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Director Network Innovation

3 months ago

Chicago, United States Blue Cross Blue Shield Association Full time

Chicago or Washington, D.C.




  • Provides strategic leadership over Provider Network Innovations for the Federal Employee Program (FEP) to innovate product offerings, to achieve customer satisfaction, to manage cost effectiveness, to deliver operational excellence, to advance quality outcomes, and to ensure compliance with Blue Cross Blue Shield Assocation FEP's contract with the Office of Personnel Management (OPM).



Job Description


  • Directs initiatives designed to advance operational excellence in relation to provider networks in support of the FEP program and the Blue Brand overall.
  • Exemplifies leadership and provides strategic direction for and on behalf of the FEP Network Innovations team to promote effective relationships with Plans, members, and internal and external stakeholders.
  • Key contributor in the development and adaptation of new Association-wide provider network initiatives to enhance FEP product offerings and promote BCBSA FEP's long-term strategy in relation to product innovation.
  • Evaluates health care legislation, business trends, and Plan commercial group activities to keep current on recent developments impacting provider network operations. Utilizes information to recommend business strategy for potential innovations.
  • Advances BCBSA's Mission and Culture by serving as a subject matter expert on behalf of the provider network team; serves a representative on multiple internal work groups and Plan advisory groups.
  • Responsible for the management of the network team, Plan and OPM issue resolution, and operations of implemented network solutions.


Additional Job Description

  • Education, Experience, and Certification
  • Bachelors Degree in health care, Business Administration or related field OR equivalent work experience (Preferred)


Preferred Certifications

  • PAHM / FAHM


Required Experience

Minimum of 10 years of health care experience (with specific provider relations/provider network and contracting experience) with progressive responsibility in a management or leadership role.


  • Knowledge, Skills, and Abilities
  • Familiarity with provider network models including tiered networks, value-based programs, patient-centered medical homes, and Centers of Excellence.
  • Experience managing staff
  • Experience developing effective partnerships with internal and external stakeholders
  • Experience leading teams and workgroups on developing consensus and resolving challenges
  • Experience with the Federal Employees Health Benefits Program (preferred)
  • Proficient in Microsoft Office – Word, Excel and Power Point
  • Outstanding oral and written communication skills
  • Excellent organizational skills with ability to handle multiple priorities at once
  • Readily able to adapt to changing priorities


Revenue Responsibility: No

  • Budget Responsibility: Minimal input - primary responsibility goes to the MD, FEP Member Benefits

People Management: Yes


Role designation: Hybrid


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