Blue Cross Blue Shield of Rhode Island

Lead Total Cost of Care Implementation Manager

Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor’s degree in business or related field, or equivalent experience
  • 3-5 years operational experience
  • Track record of vendor or client implementations
  • Knowledge of project management methodologies and Project Development Life Cycle
  • Strong leadership and problem-solving skills
  • Ability to effectively communicate and collaborate with diverse stakeholders
  • Detail-oriented with excellent follow-through.

Responsibilities

  • Lead vendor implementations and contract renewals to meet project timelines.
  • Act as Business Lead for EPMO, identifying business requirements and managing relationships.
  • Collaborate with data analysts to ensure data transfers meet vendor requirements.
  • Serve as primary contact for vendors during implementation phases.
  • Document implementations in operational guides and transition documents.
  • Facilitate meetings and lead post-implementation reviews for continuous improvement.
  • Engage with cross-functional teams to resolve issues and enhance processes.

Benefits

  • Flexible work schedules with in-office, hybrid, and remote options
  • Focus on associate well-being and work/life balance
  • Conveniently located headquarters near public transport
  • Opportunities for professional development and continuous improvement
  • Collaboration with a diverse stakeholder group in a dynamic environment.
Full Job Description

Pay Range:

$102,300.00 - $163,700.00 

Please email  if you are a candidate seeking a reasonable accommodation for the application and/or interview process.

Why this job matters:

The TCoC Program Implementation Manager is responsible for owning and managing the onboarding lifecycle of population health vendors.  Assigned vendors will include varying degrees of complexity in areas such as eligibility, engagement, file exchanges, contracting and financial arrangements, member/client communications, billing, and training of member-facing teams,   This includes but is not limited to the activities of multiple on-going implementations, daily vendor interaction and communication, timeline and critical task management, coordination across multiple  resources and stakeholders working closely with the Enterprise Project Management Office (EPMO). Accountabilities also include the timely resolution of vendor related issues as they arise.

What you will do:

  • Responsible for effective execution of vendor implementations and contract renewals with timely project completion, issue identification/resolution, and delivery per contractual terms.
  • Serve as Business Lead for the EPMO.  Facilitate identification of business requirements relative to eligibility, engagement, claims sharing, vendor and client billing, communication, member and client facing messaging and risk revenue capture.  Utilize standardized New Program Implementation Worksheet to provide a consolidated source of truth for program details.
  • Develop deep understanding of required data transfers for each vendor and work closely with the TCoC Lead Data Analyst to ensure initial data transfers meet all requirements and are balanced to internal data sources. Review and approve detailed data flows provided by the Lead Data Analyst.  Identify and implement processes to improve data accuracy including upfront data validation and automated error reporting.
  • Foster relationships with key personnel within vendors and internal teams/EPMO and participate in implementation meetings on a regular basis. Serve as main point of contact for the vendor during the implementation.
  • Fully document vendor implementations in standardized Operational User Guide and Playbook.
  • Fully prepare Vendor Transition documents to provide a detailed reference for the Clinical Programs Operations Manager for ongoing program management post implementation.
  • Facilitate meetings with task groups or functional areas as required.  Proactively engage other members of the organization with specific subject knowledge to resolve issues.  Lead post implementation review of implementations to provide lessons learned and continuous improvement.  Modify and document processes as necessary.

What you need to succeed:

  • Bachelor’s degree in business or related field, or an equivalent combination of education and experience
  • Three to five years previous operational experience
  • Established track record of vendor or client implementations
  • Project management methodologies, processes, and tools.  Knowledge of Project Development Life Cycle
  • Ability to lead and manage projects
  • Facilitate meetings and teamwork
  • Demonstrate leadership and problem-solving skills
  • Ability to think creatively and drive innovation
  • Establish and maintain strong working relationships with various stakeholders including team members, EPMO and IT resources, resources in other areas of the business and upper management
  • Ability to persuade, negotiate or influence internal and external stakeholders to build consensus
  • Ability to manage multiple priorities and resources in a dynamic environment across various departments, sites, and organize complex information
  • Proven ability to communicate, translate and execute effectively across multiple groups
  • Detail oriented with excellent follow through skills
  • Positive, energetic attitude, with the ability to handle sensitive and pressured situations
  • Able to work comfortably in a hands-on, multi-task, deadline-driven environment
  • Strong listening, verbal (especially telephone) and written communication skills are a must
  • Ability to effectively communicate with internal and external customers with a comfort level delivering presentations and meeting facilitation.
  • Proficiency with Microsoft products, i.e., Excel, PPT, Word, Project, etc.

The extras:

  • Previous vendor implementation and management experience
  • Project Management certification (PMP)
 

Location:
BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:

  • In-office: onsite 5 days per week
  • Hybrid: onsite 2-4 days per week
  • Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia
     

About Blue Cross Blue Shield of Rhode Island

Blue Cross Blue Shield of Rhode Island is a non-profit health insurance company that provides medical, dental, and vision coverage to individuals and businesses in Rhode Island. The company also offers Medicare Advantage plans and prescription drug coverage. Blue Cross Blue Shield of Rhode Island was founded in 1939 and is headquartered in Providence, Rhode Island.
Learn more about Blue Cross Blue Shield of Rhode Island
Size
800 employees
Industry
Founded
1939

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