Blue Cross Blue Shield Of Massachusetts
Healthcare
Sr.ProgramManager(CaseManagement)
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“Sr. Program Manager (Case Management) at Blue Cross Blue Shield Of Massachusetts. Skills: Case Management, Care Management, Program Management, Operations Management. Serve as operational leader. Partner with leaders”
What You'll Achieve.
Enhance program effectiveness; Enhance program outcomes; Drive quality improvements; Achieve financial goals; Achieve operational goals; Achieve clinical goals
Industry & Context.
Troubleshooting issues; Issue resolution; Defect resolution; Root cause analysis
What They're Looking For.
Must Have
7+ years managed care experience, Experience managing clinical operations, Develop and execute strategic initiatives, Multitasking skills, Exceptional communication skills, Exceptional presentation skills, Interpersonal skills, Proven leadership skills, Team building skills, Consensus-building skills, Stakeholder engagement skills
Nice to Have
7+ years healthcare leadership experience, Demonstrated ability to lead direct reports, Demonstrated ability to manage direct reports, Demonstrated ability to lead cross-functional teams, Demonstrated ability to manage cross-functional teams, Demonstrated ability to lead matrixed relationships, Demonstrated ability to manage matrixed relationships, Established track record handling ambiguous projects, Established track record handling high-stakes projects, Established track record requiring autonomy, Established track record requiring sound decision-making, Established enterprise-wide relationships
What You'll Do.
Serve as operational leader
Manage day to day operations
Provide project support
Provide program support
Serve as operational lead
Manage end-to-end operations
Lead release management
Drive system optimization
Drive member identification initiatives
Collaborate with leaders
Enhance program effectiveness
Enhance program outcomes
Collaborate with internal areas
Collaborate with external areas
Translate operational concerns
Drive workflow improvements
Analyze efficiency opportunities
Identify efficiency opportunities
Implement efficiency opportunities
Engage senior leadership
Engage external vendors
Align on strategic priorities
Align on operational goals
Spearhead complex programs
Spearhead complex projects
Ensure strategic alignment
Leverage data-driven insights
Conduct strategic analysis
Conduct qualitative analysis
Conduct quantitative analysis
Resolve complex business challenges
Develop innovative solutions
Execute innovative solutions
Enhance market demands
Drive quality improvements
Lead large-scale initiatives
Lead cross-functional initiatives
Drive operational excellence
Drive process optimization
Drive business transformation
Oversee assigned programs
Oversee vendor relationships
Collaborate with clinical leadership
Achieve financial goals
Achieve operational goals
Achieve clinical goals
Optimize business processes
Partner with technical consultants
Partner with business leaders
Align on strategic objectives
Implement system-based solutions
Implement process-driven solutions
Govern vendor release cycles
Ensure timely deployment
Ensure seamless integration
Facilitate program meetings
Lead program meetings
Document key decisions
Drive follow-up actions
Prioritize maintenance requests
Prioritize system enhancements
Prioritize defect resolution
Support continuous improvement
Execute configuration updates
Advance member identification strategies
Drive Medicare Stars initiatives
How You'll Work.
Team & Collaboration
HMM Core Application Team; Internal and external areas; Peers of analysts; Project managers; Technical consultants; Business and clinical processes; Vendor partners; Clinical leadership
Communication Scope
Presentation skills; Verbal communication; Written communication
Process & Methodology
Program management, Project management, Release management
Full Job Description
## **Ready to help us transform healthcare? Bring your true colors to blue. ** **The Role** The Senior Program Manager serves as the primary operational leader partnering with the clinical and business operation leaders executing on projects, day to day operations and overall vendor management including MHK – Care Management, Optum (Impact Pro), and Point Click Care (ADT). This role provides project and program management support for internal and external care management initiatives to Health & Medical Management. The primary responsibility is to drive engagement and lead collaboration with Health & Medical Management leaders in strategizing, coordinating, and implementing changes within the Health Management department or their assigned Care Management areas, often serving as the operational lead. Accountable for end-to-end operations management of MHK, Impact Pro, and Point Click Care, including leading release management, troubleshooting issues, and driving system optimization. Additionally, responsible for driving member identification strategic initiatives, collaboration with Digital Care Management leaders, and Medicare Stars to enhance program effectiveness and outcomes. **The Team** As an integral part of the HMM Core Application Team, the Senior Program Manager collaborates with internal and external areas across the company. The Senior Program Manager also works collaboratively with their peers of analysts, project managers and technical consultants. With a deep understanding of both business and clinical processes, the Senior Program Manager serves as a key liaison, translating operational concerns into actionable insights and advocating for Care Management and clinical teams with vendor partners. **Key Responsibilities:** * Drive operational workflow improvements by analyzing, identifying, and implementing efficiency opportunities. * Engage and influence senior leadership, external vendors, and consultants to align on strategic priorities and operational
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