When you think of where you want to go in life, being part of a great company figures into your vision. You have the talent and the drive to go far. What you want is a company with the culture and the opportunities to enable you to reach your goals.
Blue Cross Blue Shield of Massachusetts is well-known for supporting and encouraging employee achievement in an environment of abundant growth opportunities, career paths and financial rewards. You can expect no less from a health insurance leader whose innovative solutions bring coverage into the homes of millions across our state and serve as models for the entire nation.
You are invited to apply for the following opening:
Director, Network Strategy
Today's healthcare industry -- dynamic and changing at a fast pace. Recruiting talented people can mean the difference between success or failure. At Blue Cross and Blue Shield of Massachusetts, our record of achievement represents a history of hiring the best people we can find, and then challenging them to excel. It's the kind of environment that enables us to give our best to the consumers we serve, and at the same time, work to the potential of those who work for us.
Blue Cross Blue Shield of Massachusetts is an Equal Opportunity Employment/Affirmative Action Employer. Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, or any other characteristics protected by law.
This highly visible, leadership position, reporting directly to the Executive Director, Healthcare Contracting and Network Strategy is responsible for collaborating with Health Care Contract Management's (HCCM) Senior Leadership and other company leaders to develop, adapt and evolve the short and long-range provider network strategy for the corporation. This position works directly with senior leadership within the company to define and evaluate selected initiatives that have the potential to positively impact the company's long-term success. This position is directly accountable for working cross-functionally to develop and manage the company's integrated, continuous strategic and business planning process for provider networks.
Essential Functions
Qualifications
Blue Cross Blue Shield of Massachusetts is an Equal Opportunity Employment/Affirmative Action Employer. Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, or any other characteristics protected by law.
This highly visible, leadership position, reporting directly to the Executive Director, Healthcare Contracting and Network Strategy is responsible for collaborating with Health Care Contract Management's (HCCM) Senior Leadership and other company leaders to develop, adapt and evolve the short and long-range provider network strategy for the corporation. This position works directly with senior leadership within the company to define and evaluate selected initiatives that have the potential to positively impact the company's long-term success. This position is directly accountable for working cross-functionally to develop and manage the company's integrated, continuous strategic and business planning process for provider networks.
Essential Functions
- Directly accountable for managing an inclusive, continuous provider contracting and reimbursement strategic planning process, which requires extensive collaboration with HCCM and other senior leaders to create and adjust strategic areas of focus in the development of the Provider Network Strategy, including the development of provider networks and associated products. Establish key impact measures and goals to support the strategic planning process and identify the key supporting initiatives that will achieve HCCM and the company's short and long-term strategic goals and objectives.
- Responsible for development of Tactical Network Strategy, including accountability for Site of Service, Tiered Networks, Limited Networks, Specialty Care and Out of State Contracting.
- Responsible for benchmarking competitiveness of current provider networks with both local and national competitors, including review of alternative network offerings of other BCBS Plans.
- Assume a primary role assisting the Executive Director of Healthcare Contracting and Network Strategy on the development and updating of the HCCM strategic plan annually and prepare all of the supporting documents that are presented to HCCM Senior Leadership for review and approval.
- Responsible for provider contracting strategic planning process and strategy execution, including gathering, analyzing, and prioritizing development needs and requirements, defining vision, leading strategy development and working closely with product development teams, sales, marketing, and operations to ensure customer and company requirements are met, including but not limited to the following strategic planning activities.
- Development of project plans, collection of business information, and internal organizational analysis necessary to identify business drivers.
- Planning, identification, and collection of relevant data needed for strategic planning decision making.
- Categorization and analysis of collected data, including the identification, validation, and reporting of key findings, conclusions, and recommendations.
- Documenting and communicating the strategic plan to multiple audiences, including executive sponsors, stakeholders, supporting resources, and external partners.
- Ensure the successful implementation of the strategic tactical plan, including the transitioning of the plan to the appropriate supporting operational resources for implementation and the tracking and reporting of business outcomes and measures for selected tactics.
- Direct and chair provider networking strategy committees and workgroups in collaboration with other key internal areas to identify, field, and resolve internal and external provider network concerns and requests.
- Demonstrates excellent oral and written communications through organizing, running and participating in meetings and work teams, analysis and report generation, correspondence, and preparing and delivering presentations
- Developing and managing an inclusive, integrated and continuous strategic planning process that involves multiple business areas.
- Translating provider strategies into operational terms and helping business area leaders define specific tactical initiatives to achieve strategic objectives.
- Manage the annual strategic planning process. Identify and implement process improvements as needed.
- Manage the monitoring and reporting process to track progress of all strategic initiatives. Identify and implement process improvements as needed.
- Manage a new balanced scorecard that captures measures and targets for each strategic objective.
- Recruit and hire high-performing staff for the strategic planning team.
- Define recommendations for internal operational improvements, organizational effectiveness, strategic options and/or change management methods.
- Direct supervision of 1-2 professional-level associates within the strategic planning team
Qualifications
- Demonstrated knowledge and understanding of the health care industry, specifically as it relates to contemporary and future trends in the delivery, and financing of health services
- Strong understanding of strategic and operational planning concepts and methodologies
- Strong interpersonal skills and ability to effectively collaborate with and influence others at all organizational levels
- High level of organizational astuteness; professionalism and poise
- Solid knowledge of the core operational processes that exist within an insurance company
- Ability to develop and articulate general strategies and detailed operational plans
- Ability to effectively plan and facilitate organized and productive meetings/workgroups
- Demonstrated leadership skills in team and/or group settings
- Very strong communication and presentation delivery skills
- High degree of initiative along with ability to act as a team player
- Ability to deal effectively with ambiguous situations
- Executive presence
- Bachelor's Degree or equivalent required
- Masters Degree in Business Administration or other advanced degree preferred
- Demonstrated experience in strategic and operational planning
- 2-3 years experience managing and coaching others (especially professional level staff)
- 5-7 years experience in the health care industry preferred; not required
- 8-10 years of overall business experience; with progressive leadership positions in health care, financial services and/or management consulting.
- Position Information
- Location: 02215
- Job Category: Business/Strategic Management
- Reference Code: bcbs-00002400
