Staff VP, Client & Member Administration Center (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.

This is a hybrid position that requires work and residency within the state of Arizona.

Purpose of the job

Provide supervision over the enrollment and billing functions for all lines of business including Commercial Group, Individual, Medicare and Federal Employee Program (FEP). The role includes complete ownership of process management including both internal and external functions that support enrollment, all payment related services, development of short- and long-term payment operations strategies and tactical plans, problem resolutions, and full functional alignment. This individual must coordinate across team efforts and manage internal and external relationships. The role also participates in the development of strategic plans to increase productivity.

REQUIRED QUALIFICATIONS

Required Work Experience

• 10+ years in healthcare industry working in payor segment with experience in operations, finance or general management fields

Required Education

• High school diploma in general studies

Required Licenses

• N/A

Required Certifications

• N/A

PREFERRED QUALIFICATIONS

Preferred Work Experience

• 15+ years in healthcare industry working in payor segment with experience in ops, finance or general management fields

Preferred Education

• Bachelors degree in a business, healthcare, or related field

Preferred Licenses

• N/A

Preferred Certifications

• N/A

ESSENTIAL job functions AND RESPONSIBILITIES

• Motivate, manage, and lead high-performance teams involved in preparing, processing, and sustaining enrollment, including the correct filing of new member and group data
• Manages payment processing function and supporting department metrics
• Provide support and service quality to managers & team leaders when needed, including coaching and feedback reviews
• Collaborate closely with operation leaders to resolve any escalation or conflict, acting as a single point of contact and subject matter expert for enrollment and billing operation issues with all lines of business
• Collaborates closely with operation and finance leaders to resolve any escalation or conflict
• Ensure all relevant quality standards, operational & fraud risk, operational & safety policies, and procedures & control across the organization in alignment with the strategic objectives to guarantee legislative compliance relative only to enrollment and billing functions
• Address audit feedback and proactively identify risks and gaps
• Ensure reporting exists, including timely, accurate and complete reports on all internal and external enrollment and billing processes
• Oversee the development, training, and communication for onboarding of new staff
• Control the continuous improvement roadmap for enrollment and billing including identifying projects to improve efficiency and effectiveness, e.g., automation pathways
• Manages vendor relationships to ensure bills are processed and sent out in a timely manner to members to ensure an optimal member experience, acting as the ultimate business owner of the vendor relationship with procurement serving as a partner

STRATEGIC

• Develop and align strategic plans to the corporate strategic pillars for growth, net income, and customer experience
• With internal constituents, strategically plan the mission and vision for each account, with focus on large groups, to ensure flawless implementation and renewal activities for all operational activities
• Translate emerging client needs into actionable business terms and associated process enhancements
• Provide leadership and mentorship to team members on strategy, external research, best-practice analysis, business analysis, and implementation of client-centric business solutions
• Coordinate and assist in development of enhancements to existing systems or creations of new systems to improve efficiencies to enrollment and billing, including capacity modeling, workforce management, service, cost, and quality impact

OVERALL

• Oversee day-to-day departmental administration by coaching and motivating managerial staff and departmental personnel to make maximum use of experience and skills
• Monitor quality performance measures, develop and maintain effective workflows, and seek to maximize system efficiencies
• Manage use of corporate funds including budgeting, financial management, and reporting and identify opportunities to achieve administrative efficiencies while maintaining service levels
• Maintain effective working relationships to ensure teamwork in achieving corporate goals
• Coordinate activities between multiple divisions to achieve desired results
• Participate in strategic planning activities and contribute to departmental and cross-functional teams to achieve BCBSAZ goals and ensure future success
• Responsible for monitoring and meeting group performance guarantees
• Support BCBSAZs Core Value of maintaining a heritage of service, by volunteering with, serving on, and/or supporting multiple Boards of Directors within the community or other community events
• The position 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

• Deep understanding of operational, technical, and internal business processes
• Proven ability to manage individuals and diverse teams in an enrollment and billing environment
• Proficiency in business process design and bridging these to operational and technical solutions
• Resource and project management skills
• Ability to create win/win situations
• Interpersonal and oral communication skills, including presentation skills
• Strong written and verbal communications
• Intermediate knowledge of electronic data processing systems, technology, and applications
• Intermediate PC proficiency
• Intermediate skill in use of office equipment, including copiers, fax machines, scanner and telephones
• Intermediate skill in word processing, spreadsheet and database software
• Intermediate skill using departmental BCBSAZ and BCBSA software

Required Professional Competencies

• Demonstrated ability to engage with clients or external partners in a vendor/client relationship capacity
• Demonstrated ability to build implementation plans and manage cross functional teams to achieve them
• Strong familiarity with internal operational architecture and business processes
• Solid creative judgment and ability to think strategically.
• Advanced analytical and diagnostic skills dealing with issues that are often novel and not readily defined, lack known precedent or appear contradictory
• Possesses expertise in the use of formal and informal communications and has the ability to give presentations that effectively communicate goals, ideas and concepts in alignment with audience needs, including frontline employees, managers, peer leaders and executive leadership
• Management skills in an operationally changing environment, with drive for results and success based on planned objectives
• Expert knowledge of the principles and practices of healthcare prepayment
• Expert customer service skills
• Interpersonal skills that allow for harmonious relationships with providers, members and coworkers
• Interpersonal skills that allow for harmonious relationships with Group Benefit Administrator, Brokers, members and coworkers
• Recognize strategic opportunities and use data to make timely and sound decisions
• Flexibility and willingness to adjust to shifting demands/priorities
• Ability and experience to assimilate multiple new functions, services, projects and systems while maintaining existing systems and programs
• Ability to optimize resources to ensure cost effective operations. This includes proactively planning to move staff from one role to another as staffing needs change

Required Leadership Experience and Competencies

• Ability to lead others in the same or higher levels to a valuable solution that may be novel or have no known set precedence in the client experience or operational areas
• Decision analysis skills (ability to separate a complex whole into component parts)
• Ability to empower associates at all levels and encourages innovation and risk taking.
• Ability to effectively cope with multiple priorities, high customer expectations and bridge the demands between internal and external customers.
• Resource management skills with the ability to develop an enthusiastic and positive work climate.
• High standard of performance while pursuing aggressive goals
• Principled leadership and sound business ethics

PREFERRED COMPETENCIES

Preferred Job Skills

• Advanced PC proficiency
• Advanced proficiency in spreadsheet, database, presentation, and word processing software

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.