Healthcare Implementation Mgr II in Mountlake Terrace, WA

$80K - $100K(Ladders Estimates)

Premera Blue Cross   •  

Mountlake Terrace, WA 98043

Industry: Finance & Insurance


5 - 7 years

Posted 35 days ago

Who We Are

Collaborative Healthcare Solutions works to understand how customers define value and to deliver solutions through providers at the point of care. We are a strategic arm of Premera's Re-Imagine Portfolio with focused efforts on working with and through providers to improve costs, outcomes and experience for our members. Our team leverages data and analytics to help educate providers and employers on opportunities for improving cost, quality, and customer service experience through strategies such as transparency on high-value care, value-based contracting, and value-based benefit and product design.

As a Healthcare Implementation Manager II for our team you will participate in the evaluation of medical management and provider engagement. This often includes researching competitors, evaluating claim system capabilities, examining claims experience, and collaborating with internal stakeholders.

We are looking for someone who embodies the following attributes

  • Effective communicator both written and oral.
  • Can work collaboratively and strategically with leaders at all levels.
  • Someone who can execute, resolve issues and drive final results within the project management space.
  • Ability to multi-task and work well under pressure

What you will do

  • Work with HCS leadership, clinicians (physicians and nurses), actuaries, contracting managers, claims, customer service, and other internal/external customers to develop and refine medical management, contracting and provider engagement opportunities.
  • Research, analyze, develop, plan and lead implementation of Healthcare Services program changes and enhancements. This includes developing full implementation plan and establishing metrics and progress measures for evaluating outcomes of effort. Provide oversight and direction to analysts and consultants assigned components of work.
  • Acts as a Healthcare Specialist providing guidance when possible and engaging others as needed in order to achieve objectives of assigned programs, efforts, initiatives and projects.
  • Interface with managers, business owners, internal/external customers to ensure quality and timeliness.
  • Provide healthcare program expertise and consulting to Sales, Marketing, and Operations as needed.
  • Collect data using a variety of tools and methods. Analyze data and evaluate and distill analysis conducted by others, and prepare preliminary interpretations and reports summarizing and synthesizing analytical results. Use this information to develop business cases in response to findings for discussion and review with business owners.
  • Identify and recommend suggested action steps based on analytic results, makes recommendations to management/business owners.

What you will bring

  • Bachelor's Degree or four (4) year's work experience.
  • Five (5) years health care industry consulting experience or equivalent.

Valid Through: 2019-11-7