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Director, InterPlan Operations

2 months ago

Chicago, Illinois, United States Health Care Service Corporation Full time
Job Summary

At Health Care Service Corporation, we empower our employees with curated development plans that foster growth and promote rewarding, fulfilling careers. We are seeking a highly skilled professional to join our team as a Director, InterPlan Operations. This role is responsible for planning, action, and oversight of BCBSA Strategic Initiatives to ensure compliance with BCBSA InterPlan policy, mandates, and procedures.

Key Responsibilities
  • Plan, direct, and oversee construction and maintenance of HCSC capabilities to ensure compliance with BCBS Association Board Directives involving BlueCard, and internal HCSC initiatives to drive sales, retain groups, and innovate for anticipated future needs of our Enterprise and National account business.
  • Oversee HCSC compliance with Association IP Policy, as required by our Licensure Agreement with the BCBS Association.
  • Coordinate with any HCSC department (e.g. Audit, ITG, SDO, Legal, SIU), in the support and development of BlueCard appropriate/compliant responses and actions to questions and implementation of solutions.
  • Participate in the enhancement/development of IP Policy compliant service, guidelines, and procedures to support any staff initiatives necessary to the success of the BlueCard program.
  • When found out of compliance ensure appropriate reporting to the Association, develop and oversee action plans to bring HCSC into compliance.
Requirements
  • Bachelor's degree and 10 years of experience in managed care/health insurance marketing support, insurance administration or claims operations.
  • 5 years supervisory experience.
  • Knowledge of the principles and specifics of provider contracting and claim pricing methodologies.
  • Knowledge of corporate marketing practices, product lines and Par Plan operations.
  • Ability to manage multiple projects.
  • Organizational and leadership skills.
  • Interpersonal, verbal and written communication skills.
Preferred Qualifications
  • Masters Degree.
  • Experience in crisis management/incident response and protocol.

This is a hybrid role in the office 3 days/week.

We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range $115,900.00 - $215,400.00