Manager - URMBT Clinical

<p>With more than 7,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust.</p>

Detroit, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="" target="_blank" rel="noopener noreferrer">Blue Cross Blue Shield of Michigan</a> for health insurance, you can know you&rsquo;re getting much more. We're a company founded on a tradition of affordable, quality health care for everyone, improving the present and investing in the future.<br /><br />We offer:<br />Plans for employers and individuals that meet today&rsquo;s needs, budgets and lifestyle<br />The largest network of doctors and hospitals in the state<br />Lower health care costs Higher quality health care<br />Award-winning diversity practices<br />Grants and programs that promote better health throughout Michigan<br /><strong><br />Mission:&nbsp;</strong>We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health.<br /><br /><a href="" target="_blank" rel="noopener noreferrer"><strong>Click here</strong></a> to learn more about our commitment to our Social Mission, view company updates and reviews, and view our awards &amp; accolades.<br /><br />Learn more about your options as an external candidate. <a href="" target="_blank" rel="noopener noreferrer">Click here</a> to view open positions.&nbsp;

keywords: planning,organization,management,solutions,consulting,leadership,claims,goals,experience,degree,management,analysis,research,talent acquisition,planning,teamwork,compliance,communication


Competitive Total Compensation Package

Overview: <p>Responsible to plan, organize, direct, control and lead assigned business unit as well as be responsible for taking an active lead role in working with areas outside of business unit to implement new programs and program modifications.&nbsp; Position is also responsible for the servicing of major auto accounts and affiliated unions.&nbsp; Specialize in development, planning, and leadership; operate within broad objectives to ensure optimum utilization of capital, manpower and equipment for the assigned business unit to achieve business and financial goals, upon which compensation is based.</p>
Responsibilities: <ul> <li><span style="font-size: small;">Manage their own activities and a department including but not limited to planning, problem solving, staff development and communication.&nbsp;</span></li> <li><span style="font-size: small;">Execute function and/or area objectives that support continuous improvement.</span></li> <li><span style="font-size: small;">Manage professional, exempt and non-exempt, non-bargaining and bargaining unit employees.&nbsp;Interact with customers, major auto accounts and par plans.&nbsp;</span></li> <li><span style="font-size: small;">Responsible for special projects and/or problem resolutions.&nbsp;</span></li> <li><span style="font-size: small;">Provide effective and efficient solutions to complex business problems.&nbsp;</span></li> <li><span style="font-size: small;">Provide high level oversight and leadership.&nbsp;</span></li> <li><span style="font-size: small;">Act as a consultant to major auto account and union customer on all matters related to the administration of their health care benefit programs.&nbsp;</span></li> <li><span style="font-size: small;">Act as a liaison between major auto account and union customer and other claims administrators of their health care&nbsp;benefit programs.</span></li> <li><span style="font-family: Arial; font-size: small;">Other duties may be assigned.</span></li> </ul>
Requirements: <p><strong><u>Education and Experience</u></strong></p> <ul> <li>Bachelor's Degree in related field required. Master's Degree in related field considered a plus.</li> <li>Five (5) to ten (10) years experience in related field including experience in a leadership role.</li> <li>Two (2) years account or program management experience, including direct account interface and accountability for account decisions.</li> <li>Good analytical, organizational, planning and problem solving skills.</li> <li>Good verbal and written communication skills.</li> <li>Good interpersonal skills to interface one on one with subscribers, the account, union, internal support areas or outsideorganizations involved in servicing the account/union.</li> <li>Ability to work under general direction and to work effectively in a team environment.</li> <li>Ability to recognize and handle customer sensitive situations.</li> <li>Other related skills and/or abilities may be required to perform this job.</li> </ul> <p><strong><u>Supervisory Responsibilities</u></strong></p> <ul> <li>May directly supervise several employees in the assigned department.</li> <li>Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws.</li> <li>Responsibilities include interviewing, hiring, and training employees planning, assigning, and directing work appraising performance rewarding and disciplining employees addressing complaints and resolving problems.</li> </ul> <p><strong><u>Department Requirements</u></strong></p> <ul> <li>Excellent planning, problem solving, verbal and written skills to communicate complex ideas and presentations to customers.&nbsp;</li> <li>Ability to demonstrate past experience producing analytical reporting projects.&nbsp; Provide examples of reporting that demonstrates understanding of key analytic tools such as trend, cohort, and benchmark comparisons.</li> <li>Understands key clinical and population management concepts such as risk assessment, and provider attribution.</li> <li>Research and compile / analyze appropriate and relevant interventions and make recommendations for improvements. Strong experience working with&nbsp; multiple BCBSM claims and clinical data systems. (NASCO, Whyzen, BHI NDW, CPDM).</li> </ul> <p><em>All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.</em></p>