Resp & Qualifications COMPANY SUMMARY:
CareFirst, Inc., and its affiliated companies, generally referred to as CareFirst BlueCross BlueShield (CareFirst), is the Mid-Atlantic region’s largest private sector health insurer, serving the healthcare needs of 3.5 million members in Maryland, the District of Columbia, and portions of northern Virginia. The Company offers a comprehensive portfolio of products and services to individuals and groups, as well as state and federal government sponsored plans. With a market share almost three times that of the closest competitor, the company commands 45 percent penetration across the region.
In July 2018, Brian D. Pieninck assumed the role of President and CEO after serving as the company’s COO of Strategic Business Units and IT Division. Under his leadership, the organization completed an extensive review of its operations and clinical programs, resulting in an expansive 3-year strategy to grow and diversify the company’s core business. Along with a 5-year vision to drive the transformation of the healthcare experience across the continuum of its members, partners, and communities, the company has placed a renewed and intentional focus on fostering a mission-based culture, which drives every decision the company makes. The organization employs over 5,600 full-time employees in Maryland, Northern Virginia, the District of Columbia, and West Virginia. CareFirst has earned multiple workplace awards recognizing its leadership in diversity and inclusion, wellness engagement, and creation of a supportive and equitable work environment for all employees.
At CareFirst, you are part of an inspired, collaborative team that is building the healthcare experience we want for our families and our future. Every day, we make a meaningful difference in the communities where we live and work.
We practice empathy, seek to understand, invest in inclusion, demand equity and nurture belonging every day for our employees and the communities we serve. We rely on the rich diversity of our employees’ experiences and backgrounds to achieve our mission. Every year we host a Week of Equity and Action where we deepen our investment and commitment to diversity, equity, and inclusion. During this week thousands of employees engage in workshops and volunteerism with the goal of bettering themselves and our community.
- Women make up around 70% of CareFirst’s employee population, and over 50% identify as BIPOC (Black, Indigenous, and people of color).
- We have 9 resource groups that connect employees over shared identities (LGBTQ, veteran status, race, etc.) and passions (climate change, healthy living, leadership development).
- Employees are encouraged to give back and volunteer in their communities with their civic engagement hours.
As a not-for-profit, CareFirst regularly ranks among the most philanthropic organizations with $65 million invested in the community in 2020 to improve overall health, and increase the accessibility, affordability, safety, and quality of healthcare throughout its market area. The company’s employees consistently add to this impact by devoting thousands of volunteer hours to numerous community organizations and social causes. The company’s continued efforts to reinvest in community health care programs has repeatedly earned CareFirst regional accolades as a leading corporate philanthropist, including the No. 2 and No. 7 spots on the Baltimore Business Journal and Washington Business Journal’s 2019 list of top corporate givers, respectively.PURPOSE:
Within the Provider Network Operations area of Health Services, this position will support the new Provider Data management system and will manage all key aspects of systems operations, focusing primarily on system and integration testing, production issues triage and resolution, and interface monitoring/ resolutionand assisting with configuration setup. The position will also support the operations team in defining and building key operational data process with IT, work with end users to create requirements documents as needed.The Manager, Business Systems (Operations Technical Support) is critical in ensuring systems optimization and availability in a mission-critical, high availability environment.ESSENTIAL FUNCTIONS:
- Manages the team’s leadership and planning efforts. Hires, motivates, coaches, counsels, and develops team members and ensures that staff has appropriate tools and training. Evaluates performance of each team member, generates performance plans and sets goals within the context of the corporate policy. Ensures that team members are kept abreast of all relevant standards and methods. Develops and manages the team’s budget.
- Ensures successful completion of day-to-day changes, corporate initiatives, and other projects by managing team and/or matrixed resources to ensure effective Systems Development Life Cycle (SDLC) activities spanning request analysis, requirements or specifications documentation, acceptance testing, development and maintenance of operating procedures operations support, and implementation impact assessment.
- Ensures successful completion of other tasks, such as daily maintenance of systems control files, training and SOP documentation updates, processing of trading partner transaction files, updating user documentation, and production of adhoc reports. Troubleshoot and work with IT partners to resolve Provider data integration processes. Ensures development and oversees use of team controls and processes for production systems support and monitoring, which includes issue analysis ,tracking, and resolution. Document operational systems processes and work with peer managers to create process documents.
- Directs and participates in planning sessions to ensure that the team’s operations and long-range goals are coordinated with other department staff, IT, and clients. Develops and/or assists with the development of project management plans for day-to-day changes, corporate initiatives, and other projects. Provides resource estimates, timeframes, guides cost/benefit ROI business cases, and assists with the development of budgets for initiative projects. Oversees corporate processes for systems change management, spanning request submission, review, validation, prioritization, scheduling, and status reporting.
This position manages people.QUALIFICATIONS:Education Level:
Bachelor's Degree inBusiness Administration or related field OR inlieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.Experience:
- 5 years Business Analysis experience.
- 1 year supervisory or progressive leadership experience.
Knowledge, Skills and Abilities (KSAs)
- Certification in applicable domain area.
- Experience with Provider Data, Provider Data systems, IT interactions is preferred.
Department Department:Business & Project SupportEqual Employment Opportunity
- Demonstrated in-depth experience with technologies, systems, and business processes supported by the department (e.g., claims processing, enrollment and billing, financial, etc.).
- Experience in industry best practices for project management (including resource estimating, tracking, and metrics), business/systems analysis, and software testing.Demonstrated competence with full software development project life cycle.
- Must be able to evaluate demands on a timely basis and distribute resources effectively, establish and manage multiple priorities, and respond appropriately to unplanned events/projects.
- Excellent written and verbal communication, interpersonal, analytical, and problem-solving skills.
- Must have the ability to negotiate and manage customer relationships and expectations.
- Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of theCompany to provide equal employment opportunities to allqualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.Hire Range Disclaimer
Actual salary will be based on relevant job experience and work history.Where To Apply
Please visit our website to apply: www.carefirst.com/careersFederal Disc/Physical Demand
Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.PHYSICAL DEMANDS:
The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.Sponsorship in US
Must be eligible to work in the U.S. without Sponsorship