Job Description

Resp & Qualifications

PURPOSE:

The Sr. Business Consultant, Medicaid Revenue Operations provides expertise in tailored, strategic, and critical work to help design, launch, and execute programs that support initiatives for CareFirst BlueCross BlueShield Medicaid line of business. This is an exciting opportunity to help optimize a growing sector to better serve our members and community. This role reports directly to the CareFirst BlueCross BlueShield Community Health Plan Maryland, Chief External Operations Officer. The idea candidate will have had professional experience working in the Medicaid finances and/or in optimizing portfolio operations for Medicaid plans.

ESSENTIAL FUNCTIONS:

• Provide subject matter expertise in Medicaid revenue optimization, designing and executing revenue capture initiatives and driving to financial objectives with cross functional teams.
• Collaborate on the business strategy, action plan, programs and the identification of strategic opportunities.
• Proactively build and lead cross-functional teams and projects between division, and internal and external stakeholders to deliver value to supported team.
• Proactively identify ways, means, and platforms to build synergy and mutually reinforcing workstreams to accomplish tasks more effectively across different business functions of initiatives.
• Develop and manage technology platforms to track progress, programs, and impact for supported service area.
• Design and run dashboards to support clear communication across vertical components of business.
• Review and support task coordination while identifying potential process improvements.
• Develop and finalize budgets, policies, and other documentation for programs.
• Build trusted relationships within and across CareFirst to deepen subject-matter expertise, find opportunities to synchronize, and ensure close coordination with teams in their areas of responsibility.
• Identify opportunities for synergies to improve task execution across the organization.
• Work collaboratively with other support partners in our current and upcoming programs.
• Communicate strategy, programs, and next steps to leadership and our partners.

QUALIFICATIONS:

Education Level: Bachelor\'s Degree OR in lieu of a Bachelor\'s degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

Experience: 10 years experience in business development, financial management, general business operations and/or consulting experience.

Preferred Qualifications:

• MBA or other graduate degree in business related field.
• Big 4 Consulting Experience; previous experience in Medicaid markets.

Knowledge, Skills and Abilities (KSAs)

• Understands business goals and priorities.
• Follows evolving market, industry and consumer trends.
• Effective communication of complex ideas both verbal and written.
• Exceptional project management, facilitation and organizational skills.
• Excellent relationship management skills.
• Strategic thinker, problem solver, and a collaborator who can drive engagement and discussions.
• Significant experience with MS Office (Excel, PowerPoint, Word).
• Strong analytic skills utilizing tools such as Power BI, Excel, etc.
• Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Salary Range: $109,600 - $195,910

Travel Requirements:

Monthly meetings at Baltimore HQ will be required.

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilites of the position, the candidate\'s work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case\'s facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Department

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Where To Apply

Please visit our website to apply:

Federal Disc/Physical Demand

Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

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