Mgr, Operation Solutions Group

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware

Job Summary:

The Manager, Operations Solution Group leads a team that provides analytical and operational support and direction for a wide variety of initiatives aimed at optimizing operational efficiencies and improving service delivery across the Service Division. The Manager is responsible for ensuring the effective implementation one or more workstreams in the overall portfolio ($50m in 2015) of projects across the Service Division and in partnership with other divisions. Projects include, but are not limited to Blue List, CCB, operational effectiveness (BPI), new business or process implementations.

• Responsible for developing and managing business cases for major initiatives for the Service division. Ensures business cases and implementation plans are supported by deep and broad business analytics supporting critical organizational decisions regarding funding, resources and time commitments.
• Develops operational solutions and business cases with defined ROI based on deep dive analytics, clear understanding of cross division impact and downstream implications of programs, processes, new business models, and other business initiatives impacting Service Division.
• Manager leads team in one of several functional areas or workstreams, which vary based on project load in a given year.

Workstreams may include, but are not limited to

• Operational Readiness, including ensuring we have workflows for all the business teams and Service Level Agreements in place. The team will develop the workflows and get the necessary buy in to implement them from the front line operational teams.
• Command Center operations for the division. This means every time a major initiative is rolled out, this team will ensures that all factors impacting the Service Division are captured in the planning process and Service Division can implement and integrate the workflow and policy changes related to the implementation, eg Value Options, Care Core, ASO Billing, etc.
• Call Center operational efficiency projects, including but not limited to, call deflection, chat, FAQ content development, reporting, UCSW analytics, agent and people leader dashboard.
• Ensure the appropriate level of business due diligence is applied to the delivery of initiatives across service by engaging business SMEs, operational readiness and change management activities.
• Ensure the implementation of standardized business protocols and ensure the methodology is practiced consistently.
• Ensure users operationally ready to utilize new capabilities implemented.

The information above is intended to describe the general nature of the work being performed by each incumbent assigned to this position. This job description is not designed to be an exhaustive list of all responsibilities, duties, and skills required of each incumbent.

Education/Experience:

• Min of 5 years’ experience in Operations preferably in the Healthcare industry
• At least 3 - 5 years of experience in leading large programs focused on improving operational effectiveness and business capabilities
• Bachelor's Degree preferred or relevant work experience in lieu of degree
• Experience in working with senior management to align strategies and solutions
• Proven experience in process definition and implementation

Skills and Abilities:

• In depth understanding of call center and/or, claims and /or enrollment operational areas.
• Ability to perceive and understand problems, patterns, relationships between operational processes, technology and people.
• Demonstrated abilities with financial, capacity and planning skills
• Demonstrated business management leadership skills to obtain broad support and operational alignment.
• Ability to manage continuous change to energize and motivate teams.
• Strong interpersonal, collaborator and negotiating skills able to drive consensus and commitment.
• Critical thinking and problem solving ability

Salary Range:

$119,400 - $162,960

​This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:

• Comprehensive health benefits (Medical/Dental/Vision)

• Retirement Plans

• Generous PTO

• Incentive Plans

• Wellness Programs

• Paid Volunteer Time Off

• Tuition Reimbursement

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.