Mgr - IT Business Medicaid Claims Services - Hybrid

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 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 The IT Business Manager position is responsible for the Claims Services teams. The teams consist of technical resources, business analysts, and other critical roles supporting claims related aspects of the business. Collaboration with all lines of business while guiding and implementing best practices around claims processing for the organization is critical. This position is also responsible for maintaining the relationship, budget and timely delivery of several large vendor partners and tracking many smaller contracts/budgets as well. Required Qualifications Required Work Experience 3 years of leadership experience with proven ability to provide effective technical solutions to meet business needs Required Education High-School Diploma or GED in general field of study Required Licenses N/A Required Certifications N/A Preferred Qualifications Preferred Work Experience 3 years of IT management experience with demonstrated leadership responsibilities and direct people management 2 years of experience managing and leading people in an Agile environment. 2 years of experience working in health care business or IT environments Preferred Education Master’s Degree in business, computer science or related field Preferred Licenses N/A Preferred Certifications N/A Essential Job Functions and Responsibilities Develop a culture of trust, accountability, teamwork, high quality results and continuous improvement. Demonstrate leadership abilities along with good judgment and decision‑making skills. Monitor individual employee performance; help resolve both technical problems as well as human resources issues. Provide leadership and guidance to coach, motivate, and lead team members to their optimum performance levels and career development. Hold team members accountable for adhering to corporate policies and procedures. Hire and coach employees. Manage individual performance objectives and yearly reviews. Develop and maintain high performing teams that provide quality and timely delivery of business objectives. Develop, execute and maintain staffing and training plans to ensure the department is appropriately staffed and is able to provide the technical skills needed to support the enterprise. Provide recognition and corrective feedback to employees regularly Responsible to facilitate and ensure a positive employee experience in the onboarding, engagement and development of new team members in a manner that provides guidance, inspiration and accountability. Provide leadership and mentoring to team members on behaviors, processes and techniques required to successfully deliver value to the organization. Remove impediments, manage risks and resolve issues. Regularly attend team ceremonies with the exception of Retrospectives. Reinforce Agile practices with team members. In partnership with the Product Owner, drive resolution to team capacity issues. Remove impediments escalated by others relating to technical roadblocks or personnel issues. Responsible for setting and adhering to claims processing related metrics in alignment with business processes. Collaboration with all lines of business, implementing best practices related to claims processes throughout the lifecycle of a claim. Responsible for the review of IT Applications assigned to their teams. Accountable for budget oversight and license management. This responsibility also includes, in partnership with Architecture roles, developing and maintaining technology roadmaps for applications to ensure currency, best practice usage and business fit. Ensure that the application roadmap fits into the larger IT strategic plan. Expected to have a solid understanding of the projects and issues the teams is involved in and ensure communication of critical successes, issues and incidents to leadership. Assist with vendor management, as necessary. Ensure the team is completing requisite documentation such as sprint summaries, release notes, scorecards, etc. Develop scorecard and KPI metrics to be used for measuring team success and ensure compliance. Provide guidance, perform audit and ensure compliance of best practices and standards set forth in the SDLC and by governance committees. Responsible for identifying and leading IT best practice, technology enhancements or process improvements, seeking continuous improvement across application delivery teams. Facilitate/contribute to at least one “Community of Practice” that sets standards, provides shared knowledge opportunities, and oversees improvements to those specific areas related to claims processing. Lead strategic IT and business objectives that drive improvements necessary to serve the enterprise. Contribute ideas to future state technology roadmap definitions and makes recommendations to ensure effective investments are made to enable scale, quality, and maintenance and overall cost effectiveness Maintain relationships across the organization to ensure alignment of goals and consistency of practices, processes and timelines. Other duties as assigned This position has an onsite expectation of 2 days 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. Required Competencies Required Job Skills The ability to work well in a team environment and be capable of building and maintaining positive relationships with other staff, departments, and customers. Strong leadership, collaboration, and influencing skills are required. Must have the ability to persuade and build consensus cross‑functionally as an evangelist in a team‑oriented fashion. Knowledge and experience with application technologies implemented within delivery organization. Experience and knowledge in current technical architectures. Required Professional Competencies Ability to take appropriate risks, using available data. Ability to build synergy with a diverse team in an ever‑changing environment. Anticipate downstream technical needs and steer architectural designs to appropriately factor in considerations. Strong analytical skills to support independent and effective decisions. Strong verbal and written communication skills and the ability to interact professionally with a diverse group of executives, managers, and subject matter experts. Highly skilled at designing and implementing multiple tier architecture solutions, developing high‑performance and secure systems and system integration. Work effectively with management, product owners, scrummasters, business analysts, developers, technical leader, architects, system administrators, and testers, design, and deliver successful software solutions. Able to operate at varying levels of abstraction including business and product strategy, design, and implementation. Required Leadership Experience and Competencies Provide leadership, promote teamwork, meet objectives and exercise independent judgment. Experience leading and implementing projects and working collaboratively with other departments levels. Ability to prioritize tasks and work with multiple priorities, sometimes under limited time constraints. Preferred Competencies Preferred Job Skills Knowledge and understanding of health care processes and applications, specifically claims processing. Knowledge and understanding of Agile practices and application development practices. Preferred Professional Competencies Demonstrate flexibility, anticipate customer needs and effectively communicate in a timely manner consistent with the business strategy. Advanced tactical planning and decision analysis skills. Able to cope with multiple priorities and high customer expectations and bridge the demands between internal and external customers. Advanced understanding of information systems, business processes and key drivers and measures of success. Advanced analytical and diagnostic skills dealing with issues that are often novel and not readily defined, lack known precedent or appear contradictory. Develop solutions by applying accepted processes or create new approaches to leverage technology from abstract information. Advanced understanding of HIPAA transactions and privacy requirements. Presentation and public speaking abilities. Development and application of budgeting concepts, processes and procedures. Interpret medical, legal and technical data, including state and federal regulations and their effect on operations. Conceptualize new business architecture and infrastructure. Preferred Leadership Experience and Competencies Identify resources and training needs while fostering opportunities for staff growth Promote and supports the overall quality principles and company quality program. Empower associates at all levels and encourage innovation and risk taking. Develop an enthusiastic and positive work environment with positive impact to employee engagement. Negotiation and influencing skills with the ability to create win/win situations. Resource management skills. 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. #J-18808-Ljbffr Blue Cross Blue Shield of Arizona