Team Leader – Government Network Programs

Qualifications :

Required Qualifications - Must have:

• Bachelors degree or direct and applicable work experience.
• 4 years of related healthcare industry experience that reflects experience managing multiple interrelated projects which are interdependent integrated and/or highly complex.
• Strong abilities in the interpretation of data (e.g. outcomes trends assessment of benchmark data). Demonstrated problem-solving quantitative and analytical skills with the ability to recognize inconsistencies analyze for reasonableness and accuracy research and come to conclusion in a wide variety of changing analytical situations.
• Ability to build and maintain strategic ongoing relationships with colleagues and external stakeholders
• Leadership skills typically gained through a combination of project or informal leadership that demonstrates knowledge of work processes products and services and leadership competencies.
• Proven skills in motivating and influencing others; ability to build collaborative relationships across the organization.
• Effective consultation skills including the ability to persuade and influence key decision makers.
• Demonstrated ability to communicate effectively verbally and in writing expressing complex concepts clearly and concisely with multiple levels of an organization including external stakeholders and professional organizations. Ability to develop and facilitate presentations as needed.
• Ability to apply strong analytical problem solving and critical and strategic thinking to work with vendors and internal departments. Willingness to take an innovative creative approach to solving problems and developing solutions.
• Self-starter motivated by the opportunity to work in fast-paced environments and driven by measurable outcomes. Ability to operate independently yet cooperatively on teams to appropriately manage priorities while maintaining positive relations.
• Strong organization time management and prioritization skills. Ability to manage multiple projects while adjusting to changing priorities and business needs.
• Ability to develop and maintain documentation of processes and procedures and make decisions by following established guidelines.
• Proficiency with Microsoft Office applications such as Word Excel Outlook PowerPoint or Access.
• Ability to travel 5-10% of the time including overnight stays. Valid drivers license required.

Preferred Qualifications - Great to have:

• Experience leading key strategic initiatives in a matrixed environment
• Experience with CMS Risk Adjustment Care Delivery (UM and CM) and Network Strategy initiatives strongly preferred.
• Knowledge of contracting and payment strategy medical policy benefit designs and product offerings.

Additional Information :

What you will do as a Team Leader for Government Network Programs:

a. Provide leadership and day-to-day management of financial and human resources primarily focusing on employee coaching development performance improvement coordination and budgeting for staff and department(s) specific functions/services. Support business objectives and produce results that are effective accurate and timely and on target to meet HR team and stakeholder needs.

b. In collaboration with Health Networks and Government Programs and joint venture leadership define shape and drive strategies inclusive of coding accuracy and cost of care.

c. Lead a team responsible for government programs network strategies and operations. Provide ongoing monitoring and management of opportunities for total cost of care through care delivery cost of care coding accuracy programs while ensuring the strategic focus is on target with overall company strategy.

d. Serve as a key leader on MA project portfolio work as well as partner with agile product owners and product managers on strategic initiatives.

e. Facilitate discussions with senior leaders joint venture partners and cross functional business units to ensure that synergies are aligned to meet government program business objectives and key results.

f. Oversee and drive strategic initiatives for Wellmarks relationships with key health care organizations and other strategic stakeholders.

g. Oversee the management of end-to-end processes for Wellmark and is accountable for Medicare Advantage care delivery cost of care and risk programs. Lead the development and maintenance of new processes as needed.

h. Partner with internal and external partners and oversee development and maintenance of performance analytics and reporting for the area.

i. Continually assess external environment and emergence of coding accuracy and care delivery optimization activities and implications for Wellmark including analyzing and preparing information to facilitate decision-making.

j. Ensure staff are well versed in best practices and of trends and regulations related to government programs. Provide direction to ensure objectives and outcomes are met and interactions are relevant and engaging for the audience.

k. Other duties as assigned.

This job requires a non-compete agreement.

An Equal Opportunity Employer

The policy of Wellmark Blue Cross Blue Shield is to recruit hire train and promote individuals in all job classifications without regard to race color religion sex national origin age veteran status disability sexual orientation gender identity or any other characteristic protected by law.

Remote Work :

No

Employment Type :

Full-time