Job Description

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

Purpose of the job

  • Manage Commercial Segment Affordability by partnering with Analytics to identify, analyze, interpret, and validate trends, advising segment leadership team of affordability challenges and potential mitigating actions.
  • Partner with Clinical Excellence leadership to identify and implement effective utilization and care management activities, including strategic vendor partnerships as appropriate.
  • Foster a disciplined and predictable approach to managing the cost of care and financial risk for the Commercial Segment, with the goal of driving affordability and an improved member experience across the Commercial Segment. 

Qualifications

REQUIRED QUALIFICATIONS

Required Work Experience
  • 5 years of experience in analytical, actuarial or financial business analysis leadership role
  • 5 years of experience working for a healthcare organization / health insurer
Required Education
  • Bachelor’s Degree in general field of study
Required Licenses
  • N/A
Required Certifications
  • N/A

PREFERRED QUALIFICATIONS

Preferred Work Experience
  • 10 years of management or supervisory experience
  • 7 years of experience in analytical, actuarial or financial business analysis leadership role
  • 7 years of experience working for a healthcare organization / health insurer
Preferred Education
  • Bachelor’s Degree in Business, Healthcare, Mathematics, Economics, Finance or related field of study.
Preferred Licenses
  • N/A
Preferred Certifications
  • N/A

 

ESSENTIAL job functions AND RESPONSIBILITIES

 

PRODUCT AFFORDABILITY (COST OF CARE MANAGEMENT)

  • Lead Commercial Segment cost of care in identification, evaluation, implementation and monitoring of affordability and quality improvement initiatives designed to optimize the cost of high-quality medical care.
  • Partner with Clinical Excellence leadership to identify and implement effective utilization and care management activities, including strategic vendor partnerships as appropriate.
  • Partner with Analytics to identify, analyze, interpret, and validate trends and patterns Commercial Plan utilization across provider panels, care settings and other categories, advising segment leadership team of affordability challenges and potential mitigating actions.
  • Provide leadership and segment representation on corporate committees, advocating for Commercial customer needs and effectively communicating decisions and actions to segment leadership.
  • Partner with Analytics to drive design and development of tools and reports that provide valuable insights leveraging a combination of internal and external data.
  • Monitor external economic and healthcare issues affecting cost and utilization trends impacting the industry, the organization, and the segment.

SEGMENT NETWORK DEVELOPMENT

  • Prepare fact-based analysis and strategic recommendations to drive development of new/modified provider networks, including potential impacts of provider risk sharing.
  • Partner with Analytics and Provider Network teams to identify providers and locations practicing high value care for inclusion in current or future Exclusive Network offerings.
  • Lead Commercial Segment in Value-Based Partnerships, ensuring appropriate information sharing and monitoring outcome metrics in order to drive improved segment affordability and pricing predictability.

OVERALL

  • Oversee day-to-day departmental administration by coaching and motivating staff and departmental personnel to make maximum use of experience and skills.
  • Manage use of corporate funds including budgeting, financial management, and reporting. Identify opportunities to achieve administrative efficiencies while maintaining service.
  • Build and maintain effective working relationships with internal stakeholders and key external contacts to ensure teamwork in achieving corporate goals.
  • Participate in strategic planning activities and contribute to departmental and cross-functional teams to achieve BCBSAZ goals and ensure future success.
  • Drive performance through management and execution of organizational plans and activities.
  • Coordinate activities between multiple divisions to achieve desired results.
  • Support BCBSAZ’s Core Value of maintaining a heritage of service through community involvement.
  • The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
  • Perform all other duties as assigned.

competencies

REQUIRED COMPETENCIES

Required Job Skills
  • Intermediate PC proficiency
  • Intermediate proficiency with Microsoft Office, including Excel, Word and Powerpoint
  • Intermediate proficiency with Tableau or other data visualization tools.
  • Excellent presentation and communication sklls
  • Strong research and organization skills
Required Professional Competencies
  • Advanced analytical and problem solving skills necessary to generate insights and recommendations based on available data
  • Ability to recognize strategic opportunities and use data to make timely and sound decisions
  • Excellent professional and interpersonal skills, including the ability to collaborate with team members and business stakeholders at all levels of the organization
  • Advanced project management experience.
  • Flexibility and willingness to adjust to shifting demands/priorities.
  • Strong customer service skills.
Required Leadership Experience and Competencies
  • Ability to make decisions in a timely manner, sometimes with incomplete information and under tight deadlines
  • Ability to maintain high standard of performance while pursuing aggressive goals
  • Ability to influence key stakeholders to accomplish key objectives
  • Ability to maintain confidentiality and privacy
  • Principled leadership and sound business ethics

PREFERRED COMPETENCIES

Preferred Job Skills
  • N/A
Preferred Professional Competencies
  • N/A
Preferred Leadership Experience and Competencies
  • N/A

Our Commitment

AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.

Thank you for your interest in Blue Cross Blue Shield of Arizona.  For more information on our company, see azblue.com.  If interested in this position, please apply.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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