FEP Supplemental Benefit Senior Program Manager (Dental Program)

Role Overview This role manages all aspects of a large health insurance program. The manager leads contracting and implementation with the vendor partner and the Office of Personnel Management (OPM). Responsibilities include oversight of strategic business objectives, development and implementation of work plans, contract oversight of two contracts, annual benefit development, program education, and daily relationships with all program stakeholders. The position is hybrid. Key Responsibilities Develop strategic business objectives to advance the program. Lead the vendor partner and internal staff in developing and implementing a work plan to ensure strategic objectives are met. Manage contract oversight for the vendor partner and OPM contracts, including monitoring service level agreements, reporting requirements, processes, and internal controls. Lead the annual benefit development and implementation, including development of benefit changes, coordination of actuarial premium development, brochure updates, call letter responses, and negotiation of benefit changes with OPM. Serve as the subject‑matter expert for program education, including developing and maintaining relationships with vendor partner, OPM, local BCBS Plans, and internal staff, and creating educational materials (flyers, advertising materials, presentations, social media content, emails, newsletters, and wellness articles). Lead the creation, content, updates, and navigation for the program website and mobile application, and oversee the creation and updates of program digital tools. Lead all contracting and contract implementation activities, including the Request for Proposal (RFP) process, vendor selection, contracting, and contract modifications throughout the contract life cycle. Lead the application renewal process with OPM, including application response, contracting, annual contract renewal, and any contract modifications. Provide oversight of the inquiry response process to resolve questions/issues timely, accurately, and comprehensively. Ensure vendors fully cooperate and comply with all aspects of audits (financial, control performance reviews, claims reviews, information technology, information security, and Office of Inspector General). Lead role in claims oversight, grievance and appeals, provider credentialing, customer service, and utilization management. Present at meetings, conferences, community events, and open season events; conduct trainings for vendor, BCBSA, and plan staff; and represent the program at other meetings throughout the year. Qualifications Education: Bachelor’s Degree (College Degree or equivalent work experience). Experience: 5+ years in the health insurance industry and/or health care knowledge and experience. Knowledge and proven record of developing, planning, directing, and executing strategic business plans. Effective relationship skills with ability to interact and work collaboratively with internal and external staff. Knowledge and skills in contracting and contract oversight. Ability to identify and quantify appropriate metrics to determine strategic direction and success. Ability to translate technical and complicated information into member‑friendly communications. Knowledge of customer service processes and ability to ensure complex computer systems adjudicate claims correctly. Ability to work well under pressure and meet deadlines with tight time frames. Analytical, problem‑solving, organizational, leadership, and decision‑making skills. Strategic thinking skills. Outstanding written and verbal communication skills, with solid writing ability to craft comprehensive and persuasive communications. Ability to create and deliver presentations to meet the needs of the client (Plan, Agency, Member, OPM). Compensation & Benefits The posting range for this position is: $103,677.00 – $149,129.62. This role is eligible for annual bonus incentive pay and a comprehensive benefits package that includes paid time off, 11 holidays, medical, dental, vision insurance, generous 401(k) matching, a lifestyle spending account, and many other benefits for eligible employees. Note This publication may be modified in the future and the actual compensation may vary based on qualifications and business needs. This job is also eligible for annual bonus incentive pay. #J-18808-Ljbffr 001_BCBSA Blue Cross and Blue Shield Association