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.
At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:
• Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week • Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week • Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month • Onsite: daily onsite requirement based on the essential functions of the job • Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building
Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week.
This position is hybrid within the state of AZ only. This hybrid work opportunity requires residency, and work to be performed, within the State of Arizona.
PURPOSE OF THE JOB
Lead Segment specific cost of care efforts in identification, evaluation, implementation and monitoring of affordability and quality improvement initiatives designed to optimize the cost of high-quality medical care and achieve Segment specific Cost of Care savings targets.
Manage Segment Affordability by partnering with Analytics to identify, analyze, interpret, and validate trends, advising Growth and Segment leadership team of affordability challenges and potential mitigating actions.
Partner with other Cost of Care Workstreams to identify and implement Affordability Initiatives (Network, Clinical, Pharmacy, Value Based Care, Payment Integrity, Vendor Partnerships, etc.)
REQUIRED QUALIFICATIONS
Required Work Experience 5 years of experience in analytical, actuarial or business analysis 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 QUALIFICATION
Preferred Work Experience 5 years of experience in analytical, actuarial or 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 Segment specific cost of care efforts in identification, evaluation, implementation and monitoring of affordability and quality improvement initiatives designed to optimize the cost of high-quality medical care and achieve Segment specific Cost of Care savings targets.
Partner with Workstream leadership to identify and implement Affordability Initiatives impacting the Segment (Network, Clinical, Pharmacy, Value Based Care, Payment Integrity, Vendor Partnerships, etc.)
Partner with Analytics to identify, analyze, interpret, and validate trends and patterns in Segment utilization across provider panels, care settings and other categories, advising segment leadership team of affordability challenges and potential mitigating actions.
Develop business cases related to Segment cost of care initiatives to support Leadership decision-making and prioritization of opportunities based on balancing organizational alignment, ROI and resource constraints.
Provide leadership and segment representation on corporate committees, advocating for customer needs and effectively communicating decisions and actions to segment leadership.
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 as appropriate.
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 segment in Value-Based Partnerships, ensuring appropriate information sharing and monitoring outcome metrics in order to drive improved segment affordability and pricing predictability.
OVERALL
Actively engage in Segment Departmental and General Manager meetings to ensure alignment with Segment Priorities and socialization of Cost of Care initiatives.
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.
The position has an onsite expectation of 1 day per week and 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.
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 skills 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.