Blue Cross Blue Shield of Rhode Island

Lead Total Cost of Care Program Manager

Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in healthcare administration, business, finance, public health, analytics, or related field
  • 7-10 years' experience in healthcare, health plan operations, medical economics, or consulting
  • Strong analytical skills with healthcare cost data
  • Advanced proficiency in Microsoft Excel (pivot tables, complex formulas)
  • Ability to manage multiple initiatives with competing priorities

Responsibilities

  • Support planning and execution of Total Cost of Care initiatives
  • Facilitate analyses of medical cost drivers and utilization data
  • Synthesize data into actionable insights and recommendations
  • Partner with teams to quantify initiative opportunities and financial impacts
  • Track initiative status and key performance indicators
  • Monitor savings and performance against targets
  • Develop materials for governance and leadership updates

Benefits

  • Hybrid and remote work options available
  • Convenient location near public transportation in downtown Providence
  • Support for associate well-being and work/life balance
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:

Integral part of the TCOC team dedicated to managing the enterprise's medical costs while continuously improving member outcomes, quality and experience. Works closely with the Director and other key stakeholders across the organization to provide strategic, analytical and execution leadership to achieve enterprise TCOC goals.

What you will do:
  • Support the broader TCOC team with planning, sizing, and executing Total Cost of Care initiatives across key medical spend categories.
  • Facilitate analyses of medical cost drivers, utilization patterns, and trend data to inform and prioritize medical cost management opportunities
  • Synthesize complex data into clear, actionable insights for leadership, translating analytical findings into executive-ready narratives and recommendations.
  • Partner with the broader TCOC team to quantify initiative opportunities through sizing analyses, including baseline development, target population identification, and financial impact estimation
  • Track initiative status, financial impact, and key performance indicators, escalating issues as appropriate
  • Partner with analytics and finance teams to track savings and monitor performance against targets.
  • Support stakeholder engagement and follow-up actions across matrixed teams.
  • Develop materials for governance forums, leadership updates, and working sessions.
  • Identify opportunities to enhance analytical approaches, reporting, and tools supporting Total Cost of Care management.
  • Stay informed of industry trends, best practices, and regulatory considerations impacting medical cost management.
  • Perform other duties as assigned.


What you need to succeed:
  • Bachelor's degree in healthcare administration, business, finance, public health, analytics, or a related field.
  • Seven to ten years of experience in healthcare, health plan operations, medical economics, consulting, or value-based care.
  • Experience supporting or leading cross-functional initiatives with measurable financial or utilization impact.
  • Strong analytical skills, including experience working with healthcare cost and utilization data.
  • Advanced proficiency in Microsoft Excel, including pivot tables, complex formulas, and data analysis techniques.
  • Ability to assess medical cost drivers and identify actionable opportunities
  • Experience sizing initiatives, including estimating addressable population and financial impact
  • Strong critical thinking and hypothesis-driven analysis
  • Understanding of healthcare cost structures and utilization metrics
  • Advanced Excel proficiency (pivot tables, lookups, scenario modeling, macros/automation)
  • Ability to build and interpret financial models and forecasts
  • Ability to manage multiple initiatives with competing priorities
  • Strong attention to detail and accountability for outcomes
  • Ability to distill complex analytical findings into clear, executive-level messaging
  • Strong written and verbal communication skills
  • Ability to work across matrixed teams and influence without direct authority
  • Strong stakeholder management and follow-through


The extras:
  • Master's degree (MBA, MHA, MPH, or similar).
  • Experience performing initiative sizing, cost modeling, or financial impact analyses.
  • Experience with Excel macros, automation techniques, or large dataset manipulation.
  • Familiarity with health plan data environments and reporting tools (e.g., SQL, Tableau, Power BI).

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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