Manages development, execution and maintenance of multiple national scale Network Solution programs focused on, but not limited to, the Blue Distinction Centers specialty care programs, Value Based Care programs and Blue High Performance Network. Develops analytic approaches and aligns with multiple project teams including BHI. Uses both clinical and administrative data so

This position provides Workplace Services (WPS) support for all divisions and is responsible for the scheduling and coordinating daily activities, providing building and vendor management; administrator of the controlled access and security system; as well as invoice processing and expense tracking. Scheduling and coordination of furniture and equipment installation and re

Sr Consultant for multiple complex projects, services and associated deliverables related to Network Solutions initiatives. May act as project lead for implementation and maintenance of large, often national scale, complex projects. Ensure integration between BCBSA's various departments, Blue Plans and their customers, vendors and other business partners in project impleme

The Clinical Pharmacist Pharmacy Policy supports the Director Pharmacy Policy in all clinical functions including but not limited to Prior Approval policy creation and maintenance. Supports the direction for the Federal Employee Program's prescription drug benefit programs and Association initiatives to promote the cost effective use of pharmaceuticals. Provides support in

Identifies and proactively develops policy recommendations that further the BCBS mission and drive solutions to better support the over 115 million Americans BCBS Plans cover. Identifies and analyzes proposed regulatory and legislative initiatives at the federal and state level which present significant implications to BCBS Plans' members and clients. Identifies policy que

Job Description Summary The Dir Lab Precision Medicine within the GPO will lead mid and large projects/contracts to help develop strategic contracting opportunities to improve the economic and financial competitive positions of the Blue System. Provides senior management of business operations and project implementation of multiple national scale Lab/Precision medicine agr

The Senior Data Engineer will be a key resource at Synergie, supporting IT and Analytics in developing creative and innovative solutions to support business and analytic outcomes. In this exciting role on a small team, you will have a big impact by working closely with both IT and business to create new technical systems, data models and processes that support "Lowering Me

This position enacts, monitors, and operationalizes multiple components of the FEP Medicare Prescription Drug Program. Act as liaison with third party compliance help line vendor; investigate potential compliance issues. Develop internal training programs to ensure compliance with regulatory requirements. Support Medicare Compliance Officer by maintaining current CMS polic

Job Description Summary The Sr. Consultant, Events is responsible for management of conferences and events at Blue Cross Blue Shield Association including but not limited to timelines, finances, stakeholders, contracts, and event technology for internal, external, hybrid, and virtual meetings. The role will collaborate with internal stakeholders in addition to managing the

Job Description Summary Partners with stakeholders, business analysts, systems analysts and team members to understand business requirements and correlate potential technology solutions that drive the analysis and design of quality technical solutions. These solutions must be aligned with business and IT strategies and comply with the organization's architectural standards

Job Description Summary Responsible for the design, development and implementation of advanced technology systems and data standards to meet the needs of business. Partners with customers to understand business requirements to create the technical functional specifications. Acts as an internal data consultant to advise and influence business and technical partners. This ro

Synergie Medication Collective is a new medication contracting organization founded by a group of Blue Cross and Blue Shield affiliated companies to serve both Blues and select independent health plans. Synergie is focused on improving affordability and access to costly medical benefit drugs ones that are injected or infused by a health care professional in a clinical sett

Executes measures for the prevention, identification and investigation of fraud, waste, and abuse (FWA) perpetrated against the Federal Employee Program (FEP). Ensures that Blue Cross Blue Shield (BCBS) Plans and Pharmacy Benefit Managers (PBMs) meet reporting requirements as mandated by the Carrier Letter and FEP Special Investigations Unit (FEP SIU) Standards Manual. Pro

The Executive Director supports strategic and operational leadership of the BCBSA Clinical Team, including support of the creation of the clinical operations strategy and delivery of value added resources and tools. This role provides clinical expertise and population health thought leadership in support of delivering more affordable and quality care for all members. In ad

Provides oversight and management of all drug utilization and spend across both the Pharmacy and Medical drug benefit. Provides operational oversight and management of the FEP Employer Group Waiver Plan program and Medicare Part D business. Works with contracted PBM's, executives, and operational staff on ongoing contract administration and maintenance. Leads the dire