field_job_employment_type

job_industry

field_job_occupational_field_parents_all

job_organization_name

The hiring range for this role is: &nbsp;107,666.00 - 150,995.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.Key responsibility for building and maintaining critical BCBS Plan/Client relationships with management staff responsible for operational performance of the Federal Employee Program (FEP). Plays a key role in providing strategic guidance, solving complex business problems and drive organizational efficiencies to improve Plan/Client operational performance. Serves as a trusted advisor to Plan/Client, providing insights and recommendations to Plans that drives to strengthen alignment with FEP strategic business objectives and goals. Influences and directs Plans/Clients to improve operational excellence and achieve critical business outcomes that positively impact Federal Employee Member satisfaction and overall Program performance. Collect, analyze and interpret client/Plan performance data to provide innovative and data-driven solutions, unique to client/Plan needs. Plans and executes Plan Training Townhalls/Conferences that promotes comprehensive understanding and knowledge of the Federal Employee Program and fosters government contracting compliance. Monitors and assess impacts of large-scale Program-wide projects to unique Plan/Client needs. Collaborate with Plan/Client leadership to understand business goals and develop annual business plans that support their Plan/Client administrative costs budget proposals and maximize operations performance. Acts as a resource for Plan Leadership and provides guidance when needed.Influences and manages Plans relationships:<ul><li>Drives operational excellence that aligns with FEP Strategy, achieving business success measures and driving Plan satisfaction.</li><li>Provides guidance and direction to Plans to implement performance improvements and program initiatives to affect change and consistently achieve excellent performance scores on PIP and member satisfaction.</li><li>Evaluates and analyzes Plans’ internal business processes, procedures and policies to identify opportunities for process and/or performance improvements that drives operational excellence and efficient business processes that have favorable impact on the Plans' efforts to manage FEP administrative costs.</li><li>Develops and executes Plan business strategies that are aligned with the Program strategy and objectives that drive operational excellence and cost efficiencies.</li><li>Continuously monitor Plans' performance to proactively resolve issues before impacting their performance.</li></ul>Timely resolution of Plan questions and issues:<ul><li>Accountable for ensuring timely and accurate resolution of Plan questions and issues relative to operational performance and contract administration.</li><li>Partners and collaborates with other BCBSA/FEP business units, including Program Integrity, Care Management, Provider Network Management, FEP Operations Center, etc., to resolve Plan specific and global issues related to the administration of FEP as defined by the OPM contract.</li></ul>OPM/CPR audit responsibilities:<ul><li>Provides direction and support to Plans to reduce operational audit findings identified in OPM and/or CPR audits.</li><li>Consults with Plans to implement process improvements to resolve and minimize recurring OPM and CPR audit findings and reduce Program risks relative to uncollected funds for benefits overpayments.</li><li>Collaborates with Program Assurance to coordinate activities to timely resolve audit issues affecting the Plans and financial exposure to the Program.</li></ul>Annual Conference accountabilities/Project Management<ul><li>Acts as business leads accountable for planning and executing the conferences and trainings that provide a venue for all Plans to meet with the BCBSA/FEP to exchange information, provide directional guidance, and address national issues in the contract administration of FEP.</li><li>Leads and facilitates the Operations Advisory Workgroup (OAWG), which is a cross-functional Plan advisory group accountable for providing the BCBSA/FEP with recommendations and feedback on claims, customer service, and care management initiatives and policies.</li><li>Leads, plans, and executes Plan training that provides education and direction to Plans’ new management and staff responsible for FEP business functions.</li><li>Conducts and leads FEP Core Business Initiatives critical to the operations of the Program. (SC Plan and FEPOC Business Portability, FEP Business Contingency).</li><li>Provides business expertise on cross-functional projects/committees to provide guidance on issues impacting local Plans and to address/mitigate any potential adverse impact on Plans and the Program.</li></ul>Education Bachelor’s degree in business or a related discipline, or equivalent years of related experience Certifications Experience<ul><li>5+ years’ work experience, with in health insurance operations.</li></ul><ul><li>Advance experience and understanding of health plans' operational business procedures/processes.</li></ul><ul><li>Extensive experience with account/relationship management with the ability to maintain strong business relationships.</li></ul><ul><li>2 or more years’ experience working as FEP Plan leadership, in Operations with demonstrated outstanding performance.</li></ul> Skills<ul><li>Superior relationship management skills with demonstrated ability to maintain strong relationships with key with business partners.</li></ul><ul><li>Demonstrated comprehensive understanding of BCBS Plans’ FEP operations.</li></ul><ul><li>Exceptional negotiating skills with the ability to influence Client/Plans’ behavior to drive business objectives.</li></ul><ul><li>Advance analytical and conceptual skills with ability to analyze and resolve problems/issues timely and accurately.</li></ul><ul><li>Advance negotiation and strategic thinking skills with the ability to influence Client/Plans’ behavior to drive Program success.</li></ul><ul><li>Analytical skills with ability to identify and prioritize critical business issues.</li></ul><ul><li>Exceptional presentation skills and experience presenting to various size groups.</li></ul><ul><li>Excellent communication skills, both oral and written.</li></ul>People Management NO#LI_HYBRID

Blue Cross Blue Shield Association

Sr Manager Plan Ops

The hiring range for this role is: &nbsp;78,638.00 - 110,285.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.The Consultant, GPO leads smaller projects and portions of larger projects to help develop strategic contracting opportunities to improve the competitive position of the Blue System and assists in the economic and financial analysis of these opportunities. Through market research, data collection and analysis, risk evaluation, team interaction and project management the consultant is responsible for assisting in structuring supplier relationships which provide strategic and tactical solutions for Blue Plans and the Blue System. The emphasis is placed on category/contract ownership, sourcing and negotiating with suppliers to maximize the value for Blue Plans.Grows the category assigned both through the addition of new national agreements, agreement expansion and Blue Plan adoption/utilization. Responsible for the day-to-day management of contracts assigned. Organizes and synthesizes financial data and other information to identify and communicate key findings. Maintains financial viability and takes ownership of category. Prepares reports, written materials, spreadsheets, promotional materials and presentations to support the work within categories assigned. Engages Plans and suppliers regularly through 1:1 communications, meetings, presentations, webinars, etc. Conducts market research to validate category performance, identifies trends/new opportunities and is a subject matter expert within the category. Interacts with key stakeholders and external suppliers to lead in collecting information, conducting surveys and exploring potential opportunities within assigned category. Conducts RFx for assigned categories.Education: Bachelor's Degree or equivalent work experience Experience A minimum of three years related business experienceExperience in Sourcing or any related function Experience managing projects Experience creating reports/project management plans to track category progress and financial tracking Experience engaging key stakeholders and leadership Experience creating presentations, draft articles to further marketing initiatives Experience engaging various industry suppliers Experience serving as a category subject matter expert Skills Demonstrate ability to work independently and take ownership of assigned categories Strong written and oral communication and presentation skills Strong project management skills Microsoft Office products (Word, Excel, PowerPoint) People Management No#LI_HYBRID

Consultant, GPO

The hiring range for this role is: &nbsp;125,870.00 - 176,525.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.Job Description Summary: Responsible and accountable for overall delivery of Enterprise Information Technology (EIT) technical solutions initiatives. Serves as the single point of contact within EIT for delivery of complex technology solutions. Works cross-departmentally and cross-organizationally to ensure the successful delivery of EIT technology solutions initiatives.Responsibilities include but are not limited to:Technical Solution Delivery: Accountable for overall technical solution delivery for assigned initiatives. Serves as the central point of contact within the organization for successful delivery of assigned overall technical solutions. Responsible for EIT cross functional coordination (Systems Analysis, Software Engineering, Performance Engineering, Product Verification, Service Delivery, Customer) to ensure overall delivery objectives are met. Serves as the primary point of contact for Business, Senior EIT Management, and EPMO to ensure successful overall EIT technical solution delivery. Solution Delivery Controls: Establishes and maintains effective overall controls for technical solution delivery initiatives. Works with business and EPMO to define overall solution scope. Works with EIT functional teams to estimate requested scope and identify team resource work capacity. Balances scope estimates and capacity to ensure overall technical solution delivery can be successfully accomplished. Works with business and EPMO areas to address any gaps in scope verses capacity. Works with all teams to identify and document technical delivery milestone dates. Reviews estimates and verifies cross-team consistency. Accurately documents and manages assumptions for technical solutions delivery. Concisely and clearly provides status updates on technical solution delivery initiatives. Ensures adherence to all technical solutions methodology processes and practices, including reviews, walkthroughs and sign-offs. Leadership: Provides overall cross-team leadership to drive technical solution delivery to a successful conclusion. Works proactively to identify and address issues. Works with all EIT teams and BCBSA teams, to identify and implement solutions to issues. Maintains momentum of all teams to achieve overall technical solution delivery. Relationship Management: Works across all teams in a collaborative and effective manner. Navigates solutions to issues with a win-win approach, where all stakeholder needs and inputs are considered and balanced. Maintains positive and constructive working relationship with all participants in the technical solution delivery initiatives. Application of Technical Skills: Works on an as-needed basis as a hands-on technologist, applying technical skills in the development and delivery of technical solutions. Follows established technical solutions methodology processes and practices throughout the technical solutions delivery initiatives.Required Education, Certifications and Experience:Education<ul><li>High School Diploma or GED</li><li>Bachelor’s Degree in Computer Science, Information Systems, Business Administration or equivalent work experience.</li><li>Master's Degree (preferred)</li></ul> Certifications<ul><li>AWS Certified Cloud Practitioner (preferred)</li><li>Certified AWS solution architect and security (preferred)</li></ul> Experience<ul><li>Minimum 10 years of IT work experience including application system design and implementation.</li><li>Experience developing and integrating technical solution components.</li><li>Experience with Value-based, Care Management, or Disease Management analytics platforms</li><li>Experience leading technical delivery programs and projects, including, managing the full SDLC, issue/risk resolution, status reporting, dependency management, technical team communication, and deployments</li><li>Experience managing and controlling technical delivery release scope, including, soliciting business priorities from Business customer directly and leadership team, organizing scope into releases, building roadmaps, key tasks lists, manage scope changes, and communicating scope augmentations to program leadership, project management, and technical team</li><li>Experience managing technical estimates, including, estimation planning, managing the technical team to deliver estimates, and writing vendor Statement of Work verbiage</li><li>Experience with vendor relationship management, including, assuring vendors are meeting contract expectations, conducting deliverable reviews, and providing formal documented vendor feedback</li><li>Experience with program and project procurements, budgeting, and forecasting, including, managing contract project dollar allocations and progress toward contract dollar limits for all projects on contract, vetting contract modifications, partnering with enterprise procurement team, and approving invoices</li><li>Experience with implementing and identifying opportunities for project/program technical delivery improvements, including, process improvements, quality management improvements, knowledge sharing/knowledge management improvements, collaboration tool improvements, and program reporting tool improvements</li><li>Experience with multiple development methodologies, including RUP and Agile.</li><li>Experience in Office 365 suite of tools, including but not limited to SharePoint Online, Groups, Teams, Yammer, OneDrive, Power BI, Power Automate.</li><li>Blue Cross Blue Shield Plan experience (preferred)</li></ul> Skills<ul><li>Strong background and deep understanding of healthcare industry Value-based, Care Management, or Disease Management data, Business processes, and their member lifecycle</li><li>Ability to discuss key Value-based, Care Management, or Disease Management topics and analytics with Business partners at their level of competence of the topic</li><li>Strong facilitation skills with driving Business experts to decisions and technical teams to solutions</li><li>The ability to develop and maintain business relationships</li><li>Excellent presentation development skills and verbal presentation skills</li><li>Strong technology project management skills</li><li>Strong team-oriented interpersonal and communication skills to cultivate positive working relationships</li></ul> People Management<ul><li>No</li></ul>#LI_HYBRID

Technical Solutions Director

The hiring range for this role is: &nbsp;$180,000.00 - $215,000.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.Job Description Summary The Managing Director, Security Operations, Incident Response &amp; Threat Hunting will manage the team responsible for various security services in domains of Security Operations, Incident Response, and Threat Hunting. This role will lead a team of security engineers, analysts, and administrators responsible for maintaining security infrastructure, responding to security alerts, investigating/triaging security incidents, performing forensics detailed forensics analysis, building detection and monitoring rules, and building custom incident response tooling.Responsibilities include but are not limited to: ​<ul><li>Manage all SoC operations, technology administration, threat hunting programs, Incident response processes.</li><li>Establish processes to measure and report on team performance and business value.</li><li>Work with various business stakeholders to demonstrate the business value and operational outputs of the team at an executive level.</li><li>Ensure that forensic evidence is preserved and can be used for legal proceedings if necessary.</li><li>Research and monitor emerging security technologies, understand current industry and technology trends and opportunities, and assess their impact to the business.</li><li>Conduct research to identify new attack vectors facing BCBSA computing environment.</li><li>Work with and influence business contacts in regards to technology controls, risk mitigation techniques related to application layer security.</li><li>Develop and maintain applicable incident management program metrics for continual measurement and improvement.</li><li>Manage and motivate teams with diverse skills and backgrounds.</li><li>Assess and prioritize security risks and formulate effective risk management mitigation plans.</li><li>Collaborate with cross-functional teams to integrate security measures into business processes and applications.</li><li>Regularly review and update security documentation to reflect changes in the threat landscape and business requirements.</li><li>Participate in security audits, assessments, and certification processes.</li><li>Work closely with legal and compliance teams to address any security-related legal and regulatory requirements.</li><li>Lead incident response efforts, including investigation, containment, and resolution.</li><li>Lead post-incident analysis and implement corrective actions to prevent future occurrences.</li><li>Participate in the selection, implementation, and maintenance of security technologies.</li><li>Communicate effectively with stakeholders, addressing security concerns and providing guidance on best practices.</li><li>Assist in security-related documentation (RFPs, PPTs, etc.)</li></ul>Required Education, Certifications and Experience<ul><li>Bachelors Degree Computer Science, Information Technology, or related field required.</li><li>Minimum of 10 years information security experience with a heavy technical focus and with 7 years of progressively increasing responsibility.</li><li>Minimum of 5 years in a leadership position as a hiring manager or team lead capacity with experience developing and leading staff.</li><li>Experience/knowledgeable in conducting audits of information systems and their application to ensure accuracy of information and promote operational efficiency</li><li>Experience acting in a security incident response role with responsibility of analyzing alerts/threats, responding accordingly, developing incident response plans and procedures</li><li>Experience documenting incident cases and managing lessons learned meetings</li><li>Experience in working with Managed Security Service Providers (MSSPs) and ensuring alignment to agreed upon SLAs.</li><li>Experience in implementing and managing core TVM systems and processes such as: Security Event Management, Vulnerability Management, Web application firewall, data base monitoring, forensics toolsets, firewalls, proxies, packet captures, etc.</li><li>Experience in managing Information Security operational and capital budgets.</li><li>Experience with implementation of technical security architectures within a large enterprise environment is preferred.</li><li>Competency in making operational decisions, monitoring progress and reporting results.</li><li>Ability to communicate at all levels, with experience in leading operational review meetings with business partners and executives that may range from technical resources to VP/SVP.</li><li>Technical domain knowledge along with understandings for the costs for delivering the required services</li><li>Competency to Interpret and summarize technical information for presentation to non-technical business contacts</li><li>Knowledgeable in security technologies, procedures, and best practices to include functions such as Web Application Firewalls, Intrusion Detection Systems, Endpoint Detection and Forensics, SIEM, and Vulnerability Scanning</li></ul>Preferred Education, Certifications and Experience<ul><li>CISSP, CRISC, CISA or other relevant certifications preferred</li><li>Knowledge of the BCBS system and practices.</li></ul>People Management Yes #LI-Hybrid

Managing Director,  Secuity Operations

The hiring range for this role is: &nbsp;107,666.00 - 150,995.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.Develop product strategies and solutions to address emerging regulatory and market requirements for national healthcare delivery using agile development methodologies. Provides project leadership and interfaces with Blue Plans across the System and various technology and analytical teams/applications. Supports the analysis and design of business processes that address national market requirements and/or supports new technical implementations. Responsible for defining business requirements and enhancements obtaining appropriate approvals from governing committees as needed as well as supporting through implementation including training and documentation.Conducts detailed research on emerging business opportunities, including impacts to business models for various operational functions across healthcare. Leads the development and presentation of materials to various audiences across Blue Plans to obtain direction to meet market and business needs. Conducts requirements gathering and analysis to support business needs, and develops strategy, policy, and operational recommendations for leadership. Develops the required business case and vision based on input from Sr. Management, Plan executives, user groups, workgroups or governance representatives. Works with business and technical teams to assure effective development, testing and implementation of new capabilities using agile methodologies. Presents project scope, status and coordinates trainings to various levels of staff. Lead pilot and all Plan implementation efforts. Develops manuals and educational materials in support of Plan training on new technical opportunities including SOPs, user guides, training presentations, all-Plan calls and demos, best practice sharing forums and others. Partners with Plans in training internal staff. Create, Manage and present project roadmap, scope, status and other various project updates for Plans and internal leadership. Partners with Plans and BCBSA staff to ensure clear understanding of timeframes, deliverables, business expectations, and anticipated outcomes. Coaches and mentors business and scrum team membersEducation Bachelors and or Masters Degree. Experience Seven years’ experience in a combination of both product/business development and operations within the healthcare industry Minimum of five years’ experience in business process design analysis as well as business system design. Blue Cross Blue Shield experience Demonstrated experience managing a full product development cycle using agile methodologies Conceptual experience in systems development, designs and methodologies Skills Understanding of agile development methodologies. Strong background of Health Care industry and Health insurance processes. Project management/leadership Relationship development across various levels of staff. Strong communication, writing and presentation skills Strong organizational and multi-tasking skills Ability to motivate others to work together as part of a team is key Ability to negotiate solutions to problems independently People Management No#LI-Hybrid

Business Operations Design Manager

The hiring range for this role is: &nbsp;125,870.00 - 176,525.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.Job Description Summary The Network Security Engineer will design, develop, test, deploy and maintain services, features and functions that will enhance security posture and controls for enterprise networks. Ensure systems are up to date with latest security patches and implemented with operational resilience. This position will assist in performance improvement while ensuring security controls are in place protecting the network and data. This position requires collaboration with governance and architecture groups to design solutions that meet business and security requirements. Responsible for creating and maintaining a network security fabric that articulates the architectural vision, conceptualizing and experimenting with alternative technical approaches, creating models, components and interface specification documents and validating the architecture against requirements and assumptions. Accountable for developing a consistent framework for future BCBSA technology decisions. Provide senior level expertise related to decision-making and priorities for the enterprise network security. Responsible for ensuring necessary controls are part of technical designs to address the confidentiality, integrity, and availability (CIA) of IT systems and applications.Responsibilities include but are not limited to:Develops and maintains internal and external professional networks to track strategy, governance and organizational effectiveness trends and issues. Establish strategic relations with key technology vendors in order to influence changes in future product releases. Interacts with a wide range of technical and healthcare industry contacts. Researches and benchmarks best practices and/or products in the area of security technology. Routinely gathers and assesses changing BCBSA business needs. Analyzes and modifies enterprise network security technology strategy. Analyzes how business processes interact with technology to create value for the business. Studies core technologies and infrastructure. Maintains knowledge of security technology, trends, and standards. Provides input to the content of Requests for Information / Proposal (RFI/P) around the BCBSA technology requirements and guiding principles. Conducts trend analyses to track emerging industry trends and technologies. Creates network security engineering designs (BCBSA accepted technology products, configurations, standards, processes, policies, etc.) for utilizing technology assets in the company. Works with internal teams to set direction around network security for the organization. Assure that a workable, understandable and agreed upon approach for acquiring and utilizing technology is available and utilized. Seeks approval for designs from appropriate approval bodies. Evaluate/factor in the cost-benefit for each proposed design or changes to design. Design and lead the implementation of an enterprise-wide technical solutions based on architecture and enterprise business requirement needs. Facilitate the development of standardized procedures to provide a common process to integrate the deployment of new tools, techniques and technologies to existing IT processes. Influence the prioritization of initiatives outlined in the migration plan (what components to tackle first or trade-offs to make to progress toward the end state). Analyze current technology environment to detect critical deficiencies and recommends solutions for improvement. Develop and document the principles and frameworks that guide the adoption and implementation of enterprise architecture decisions. Develop mechanisms to maintain and support the architecture process. Facilitate the development of enterprise governance in collaboration with business and technical leadership. Present technical designs to appropriate architectural approval bodies. Obtain sign-off for designs. Develop, maintain and educate the corporation and facilitate adherence to enterprise architecture and standards. Accountable for increasing the company understanding of network security design, standards and associated procedures. Provide engineering consultation to the organization and influences the architecture process, its outcome and ongoing results. Gain alignment and buy-in of architecture. Clarify understanding of standards. Build credibility with clients and technical staff through the delivery of sound business technical solutions. Consults with business and technology project staff to fit systems to architecture and identify when it is necessary to modify technical designs to accommodate project needs. Provide leadership for the development, maintenance, corporate education and adherence to enterprise technology architecture and standards on an enterprise-wide basis. Guide decision-making for selection, deployment, maintenance and retirement of technologies at BCBSA. Perform agreed upon compliance activities such as quarterly firewall policy audits, remediation of audit findings, management and tracking of vulnerability finding, etc. Complete routine maintenance on security appliances and tools including firewall policy changes as requested by internal customers. Work with service provider to manage and monitor DDoS policy. Participates in troubleshooting activities as required and provides security reports as needed. Lead/oversee the construction, implementation and maintenance during the life cycle of the solutions. Provide the technical leadership to developers, systems analysts and other IT technicians to ensure the successful delivery of the solution. Oversees technical implementation and modification activities. Serve in a compliance review for project designs and deliverables. Oversee the evaluation and selection of hardware and software product standards, and the design of standard configurations. Provide technical governance and support over the architectural design stages of projects. Provide recommendations of the enterprise strategy and architecture governance process. Evaluate the success of architecture designs as they are implemented. Evaluate strengths and flaws in architecture designs for continuous improvement.Required Education, Certifications and Experience:Education<ul><li>Bachelor’s Degree in a technical or business discipline or equivalent work experience in similar environment.</li></ul> Certifications<ul><li>Professional certification in Network Security Administration and/or Network Engineering (CISSP, CCNA, CCDA, CCIE,) is preferred.</li></ul> Experience<ul><li>Minimum 10 years of progressive, broad applied technical work experience doing technology configuration, deployment and systems integration.</li><li>Experience with Palo Alto and Cisco firewalls, IDS/IPS, DLP, IP Filtering, DDoS, services, AlgoSec or other security policy management solution, VPN, Remote Access and other perimeter security technologies.</li><li>Experience with designing and implementing layered network security defenses.</li><li>Experience in creating, documenting and communicating architectural designs for a system comprised of many sub-components.</li><li>Experience in creating, documenting and communicating architectural designs for a system comprised of many sub-components; experienced in consulting / negotiating formally and informally with others.</li></ul> Skills<ul><li>Familiarity with Routers, Switches as well as experience with the following protocols (TCP/IP (v4 and v6), RIP, OSPF, EIGRP, BGP and HSRP) would be preferred.</li><li>Proficiency in producing realistic and achievable deployment plans.</li><li>Solid understanding of current and emerging technologies with advanced knowledge of one specific technology; solid understanding of operational business practices.</li><li>Solid understanding of what health care companies are doing with respect to technology and practices is preferred.</li><li>Good understanding of BCBSA business strategies is preferred.</li></ul> People Management No

Network Security Engineer

The hiring range for this role is: &nbsp;125,870.00 - 176,525.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.Serves as clinical director of the Federal Employees Program pharmacy programs. Provides leadership and direction for the Federal Employees Program prescription drug benefit programs and Blue Cross Blue Shield Association initiatives to promote the cost-effective use of pharmaceuticals. Provides leadership in the development, management and evaluation of the Service Benefit Plan Formulary. Keeps abreast of and interprets trends within the pharmaceutical marketplace and healthcare industry which could affect pricing, delivery system, and benefit coverage and provider utilization and formulates strategies to respond to trends. Project responsibilities include project coordination, ability to set priorities, consensus building and providing reports to both peers and Executive level.Primary Job Functions<ul><li>Develops, manages, and evaluates drug formulary, drug utilization review programs, fraud and abuse programs, safety and quality monitoring programs. In addition, provides oversight over Pharmacy Benefit Manager clinical programs.</li><li>Interacts significantly with the Pharmacy and Medical Policy Committee as policies are being drafted for final review of the full Pharmacy and Medical Policy Committee. Has oversight of the contract and activities of support vendor for Pharmacy and Medical Policy Committee: creation of monographs, drug and class reviews. Presents recommendations for final vote of from Pharmacy Policy to Pharmacy and Medical Policy Committee members.</li><li>Formulates and coordinates integration of pharmacy clinical programs with overall Federal Employees Program administrative policy.</li><li>Provides leadership and support to pharmacy work groups, best practices, and forums.</li><li>Initiates new programs for managing utilization and increasing cost savings.</li></ul>Education Required: Doctor of Pharmacy degreeExperience:Required: A minimum of 5 years related work experience including 3 years in a leadership role.Certifications Required: Currently licensed as a pharmacist in the state of Maryland Knowledge, Skills, and Abilities<ul><li>Knowledgeable about how health care and patient care is delivered and how health care professionals interact in the health care environment, e.g., progressive experience in managing drug utilization review and formulary programs as well as Pharmacy and Therapeutics Committee experience.</li><li>Technical proficiency with information technologies (Microsoft software applications) is required.</li><li>Excellent interpersonal skills and presentation skills, including the ability to work with all levels of the Association, Plans, government agencies and vendors.</li><li>Leadership, organizational, analytical, and project management skills are also imperative, as well as the ability to solve problems, make sound business decisions, and communicate effectively, both in writing and orally.</li></ul>Revenue/Budget Management: NoPeople Management: NoTravel Requirements: 11-25%#LI-Hybrid

Director of Pharmacy Policy

The hiring range for this role is: &nbsp;78,638.00 - 110,285.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.The "Consultant Employer Group Waiver Plan (EGWP) Operations position supports the vendor relationship, daily operations, and delivery of member benefits for Medicare Part D Employer Group Waiver Plan (EGWP). This position collects, maintains, and resolves issues, shares program operational and performance data, supports timely resolution of inquiries, communication development, process documentation, reporting, implementation, compliance, and audit activities in support of and in compliance with the Federal Employee Program (FEP) Program, CS 1039, Office of Personnel Management (OPM), and Centers for Medicaid Services (CMS) EGWP Part D policies and regulations.Primary Job Functions<ul><li>Oversees accurate and timely resolution of member inquiries including but not limited to CMS, OPM, internal and external sources.</li><li>Identifies performance and compliance risks and communicate to leadership timely to minimize non-compliance. Reviews and tracks weekly, monthly, and quarterly reporting to identify any issues and implement corrective action strategies as needed.</li><li>Assists with managing, tracking and approvals for communication requests, system updates, benefit changes in compliance with CMS and FEP requirements/standards.</li><li>Support and interact with internal and external stakeholders to provide timely resolution to inquiries and issues.</li><li>Fosters collaborative relationships with internal and external stakeholders and vendor account teams.</li></ul>Increase Program value:<ul><li>Implements new programs to increase the value of our services. This includes planning, implementation, data analysis, communications, and outcome management.</li><li>Review trends and industry information to determine best practices, operational efficiencies, or process improvements to enhance program performance and the member experience.</li></ul>Compliance:<ul><li>Support development of operational standard operating procedures (SOP), policy, brochures, training materials and curriculum.</li><li>Assist and support contract proposals, negotiations, counter proposals, SLA development, contract modifications and amendments.</li><li>Coordinates the development and maintenance of program reporting and continuous review for outcomes in alignment with FEP goals.</li><li>Support audit and compliance activities.</li></ul> EducationRequired: Bachelor’s degree in Pharmacy, Business, Accounting, Management, Health Services, Information Systems or equivalent work experience. Experience Required: Minimum of three years of experience within a business environment services delivery setting, with experience in project management, and/or healthcare informatics Preferred: • Experience in project management and/or account management• Experience setting priorities and meeting objectives for projects with multiple stakeholders• Technical proficiency with Microsoft Office, Teams and SharePoint Knowledge, Skills, and Abilities<ul><li>Project management skills for reporting multiple projects, involving multiple stakeholders, under tight deadlines</li><li>Advanced organizational skills with the ability to develop approaches that meet required objectives</li><li>Excellent communication (written and oral) and interpersonal skills with an ability to communicate to small and/or large audiences (both internal and external to BCBSA)</li><li>Technical proficiency with information technologies (e.g. Microsoft software applications)</li><li>Interpersonal skills with the ability to work with all levels of the Association, Plans, government and vendors</li><li>Ability to manage stakeholders and reconcile and integrate competing interests</li></ul>Revenue/Budget Responsibility: No People Management: NoTravel Requirements: 11-25%#LI-Hybrid

Pharmacy Technician Consultant  (Part-D)

The hiring range for this role is: &nbsp;78,638.00 - 110,285.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.The Consultant Employer Group Waiver Plan Operations position supports the vendor relationship, daily operations, and delivery of member benefits for Medicare Part D Employer Group Waiver Plan (EGWP). This position collects, maintains, and resolves issues, shares program operational and performance data, supports timely resolution of inquiries, communication development, process documentation, reporting, implementation, compliance, and audit activities in support of and in compliance with the Federal Employee Program (FEP) Program, CS 1039, Office of Personnel Management (OPM), and Centers for Medicaid Services (CMS) EGWP Part D policies and regulations.Primary Job Functions<ul><li>Oversees accurate and timely resolution of member inquiries including but not limited to CMS, OPM, internal and external sources.</li><li>Identifies performance and compliance risks and communicate to leadership timely to minimize non-compliance. Reviews and tracks weekly, monthly, and quarterly reporting to identify any issues and implement corrective action strategies as needed.</li><li>Assists with managing, tracking and approvals for communication requests, system updates, benefit changes in compliance with CMS and FEP requirements/standards.</li><li>Support and interact with internal and external stakeholders to provide timely resolution to inquiries and issues.</li><li>Fosters collaborative relationships with internal and external stakeholders and vendor account teams.</li></ul>Increase Program value:<ul><li>Implements new programs to increase the value of our services. This includes planning, implementation, data analysis, communications, and outcome management.</li><li>Review trends and industry information to determine best practices, operational efficiencies, or process improvements to enhance program performance and the member experience.</li></ul>Compliance:<ul><li>Support development of operational standard operating procedures (SOP), policy, brochures, training materials and curriculum.</li><li>Assist and support contract proposals, negotiations, counter proposals, SLA development, contract modifications and amendments.</li><li>Coordinates the development and maintenance of program reporting and continuous review for outcomes in alignment with FEP goals.</li><li>Support audit and compliance activities.</li></ul> EducationRequired: Bachelor’s degree in Pharmacy, Business, Accounting, Management, Health Services, Information Systems or equivalent work experience. Experience Required: Minimum of three years of experience within a business environment services delivery setting, with experience in project management, and/or healthcare informatics Preferred: • Experience in project management and/or account management• Experience setting priorities and meeting objectives for projects with multiple stakeholders• Technical proficiency with Microsoft Office, Teams and SharePoint Knowledge, Skills, and Abilities<ul><li>Project management skills for reporting multiple projects, involving multiple stakeholders, under tight deadlines</li><li>Advanced organizational skills with the ability to develop approaches that meet required objectives</li><li>Excellent communication (written and oral) and interpersonal skills with an ability to communicate to small and/or large audiences (both internal and external to BCBSA)</li><li>Technical proficiency with information technologies (e.g. Microsoft software applications)</li><li>Interpersonal skills with the ability to work with all levels of the Association, Plans, government and vendors</li><li>Ability to manage stakeholders and reconcile and integrate competing interests</li></ul>Revenue/Budget Responsibility: No People Management: NoTravel Requirements: 11-25%#LI-Hybrid

Pharmacy Operations Consultant (Part-D)

The hiring range for this role is: &nbsp;125,870.00 - 176,525.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.Job Description Summary The Director leads the holistic strategy for employee development through programs, resources and experiences that align with and build organizational culture and capability. Leads the design and creation of a holistic employee learning experience that supports current as well as future organizational needs. Provides thought leadership and strategy to grow all employees through assessment, experiences and formal learning modes with resources needed to cultivate and advance organizational capabilities and drive business outcomes. Manage budget and vendor relationships. Has an on-going understanding of external trends and insights; integrates the same into our organization to promote effective delivery and sustainability of learning. Researches and leverages industry trends, benchmarks and best practices as well as internal data to provide guidance and influence the strategic development and deployment of resources.Responsibilities include but are not limited to:<ul><li>Leads the design, development, implementation, delivery and measurement of employee development strategies that maximize employee potential and build capabilities needed to achieve organizational priorities. Identifies and manages key vendors. Is accountable for a variety of modalities (computer-based learning, assessments, etc.) and programming to enhance learning and its lasting impact on individuals and the organization.</li><li>Facilitates learning sessions as well as may act as a collaborator or coordinator for sessions for groups of varying sizes.</li><li>Strategizes and links multiple stakeholders, partners, teams, systems and activities across the company to connect a holistic employee learning and development strategy and employee experience.</li></ul>Required Education, Certifications and Experience<ul><li>7 or more years in employee development, effectiveness or communication roles</li><li>Demonstrated experience leading projects and/ or programs with cross functional teams through successful completion.</li><li>Experience designing and analyzing employee development programming, that are connected to the vision, strategies and cultural expectations of the organization</li><li>Experience selecting and managing vendors and other delivery (internal) partners</li><li>Strong/demonstrated capability for designing and leading large, facilitated experiences, virtual and in person.</li><li>Brings innovative ideas to market, has good judgement about what ideas will work within the organization</li><li>Drives for results effectively and looks for ways to gain feedback and continuously improve processes and outcomes</li><li>Prioritizes competing initiatives and spends time and resources on what’s most important</li><li>Relationship generator, strong collaborator, influencer and creates a sense of belonging and inclusion within team</li><li>Designs and consults with the employee experience in mind</li><li>Strong presentation, training and development skills</li></ul>Preferred Education, Certifications and Experience<ul><li>Bachelors Degree</li><li>Background and experience in Learning &amp; Development, Talent Development, Talent Management, or Organizational effectiveness</li></ul>People Management No#LI-HYBRID

33 Blue Cross Blue Shield Association Jobs