Lead Total Cost of Care Implementation Manager

Pay Range

$102,300.00 - $163,700.00

Please email ***email_hidden*** if you are a candidate seeking a reasonable accommodation for the application and/or interview process.

At BCBSRI, our greatest resource is our people.

We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do—not just for our members, but for our employees as well.

We recognize that to do your best work, you have to be your best self.

It’s why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees.

Our culture is one of belonging.

We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you’re at in the organization, you’re an integral part of our team and your input, thoughts, and ideas are valued.

Join Others Who Value a Workplace For All.

We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders.

We’re dedicated to serving Rhode Islanders.

Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state—building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer.

Why This Job Matters

The TCoC Program Implementation Manager is responsible for owning and managing the onboarding lifecycle of population health vendors. Assigned vendors will include varying degrees of complexity in areas such as eligibility, engagement, file exchanges, contracting and financial arrangements, member/client communications, billing, and training of member-facing teams, This includes but is not limited to the activities of multiple on-going implementations, daily vendor interaction and communication, timeline and critical task management, coordination across multiple resources and stakeholders working closely with the Enterprise Project Management Office (EPMO). Accountabilities also include the timely resolution of vendor related issues as they arise.

What You Will Do

• Responsible for effective execution of vendor implementations and contract renewals with timely project completion, issue identification/resolution, and delivery per contractual terms.
• Serve as Business Lead for the EPMO. Facilitate identification of business requirements relative to eligibility, engagement, claims sharing, vendor and client billing, communication, member and client facing messaging and risk revenue capture. Utilize standardized New Program Implementation Worksheet to provide a consolidated source of truth for program details.
• Develop deep understanding of required data transfers for each vendor and work closely with the TCoC Lead Data Analyst to ensure initial data transfers meet all requirements and are balanced to internal data sources. Review and approve detailed data flows provided by the Lead Data Analyst. Identify and implement processes to improve data accuracy including upfront data validation and automated error reporting.
• Foster relationships with key personnel within vendors and internal teams/EPMO and participate in implementation meetings on a regular basis. Serve as main point of contact for the vendor during the implementation.
• Fully document vendor implementations in standardized Operational User Guide and Playbook.
• Fully prepare Vendor Transition documents to provide a detailed reference for the Clinical Programs Operations Manager for ongoing program management post implementation.
• Facilitate meetings with task groups or functional areas as required. Proactively engage other members of the organization with specific subject knowledge to resolve issues. Lead post implementation review of implementations to provide lessons learned and continuous improvement. Modify and document processes as necessary.

What You Need To Succeed

• Bachelor’s degree in business or related field, or an equivalent combination of education and experience
• Three to five years previous operational experience
• Established track record of vendor or client implementations
• Project management methodologies, processes, and tools. Knowledge of Project Development Life Cycle
• Ability to lead and manage projects
• Facilitate meetings and teamwork
• Demonstrate leadership and problem-solving skills
• Ability to think creatively and drive innovation
• Establish and maintain strong working relationships with various stakeholders including team members, EPMO and IT resources, resources in other areas of the business and upper management
• Ability to persuade, negotiate or influence internal and external stakeholders to build consensus
• Ability to manage multiple priorities and resources in a dynamic environment across various departments, sites, and organize complex information
• Proven ability to communicate, translate and execute effectively across multiple groups
• Detail oriented with excellent follow through skills
• Positive, energetic attitude, with the ability to handle sensitive and pressured situations
• Able to work comfortably in a hands-on, multi-task, deadline-driven environment
• Strong listening, verbal (especially telephone) and written communication skills are a must
• Ability to effectively communicate with internal and external customers with a comfort level delivering presentations and meeting facilitation.
• Proficiency with Microsoft products, i.e., Excel, PPT, Word, Project, etc.

The Extras

• Previous vendor implementation and management experience
• Project Management certification (PMP)

Location

Role

BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:

• In-office: onsite 5 days per week
• Hybrid: onsite 2-4 days per week
• Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia

Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today’s healthcare industry. BCBSRI is an equal opportunity employer.

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