Blue Cross NC ยท 7 hours ago
Principal Project/Program Manager (Corporate Pharmacy)
United States
Full-time
Remote
Senior Level
5+ years exp
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Responsibilities
Leads and manages the day-to-day operational and tactical aspects of all Medicare related pharmacy benefit management (PBM) activities, new initiatives, and other ongoing business deliverables in accordance with business needs.
Identifies, evaluates, and resolves issues with PBM related deliverables.
Resolves issues by utilizing facts, knowledge, and experience to steer towards favorable business outcomes.
Serves as a trusted solutions advisor by developing strong stakeholder relationships.
Collaborates closely with project team members, business owners and sponsors to develop and successfully implement projects/programs.
Assesses ongoing performance risks and communicate trends to develop next best action.
Oversees program to ensure initiatives have required resources, meets milestones, and are successfully implemented.
Leads and coordinates matrixed and/or cross-functional team.
Articulates complex concepts that can cause a roadblock and puts forward proposal to advance projects / programs.
Develops project plans and recommendations in support of Corporate Pharmacy objectives and leads implementation; tracks and reports on the status of efforts related to our PBM.
Must ascertain, categorize, and manage projects in relation to corporate priorities.
Negotiates resources to staff projects effectively with appropriate skill sets, aligning skills to the project's needs.
Delegates work as required and ensures a quality end product through close customer contact and assesses customer/client satisfaction through direct feedback/evaluation.
Coordinates development and implementation of policies and procedures as well as development of compliance measurements.
Controls and monitors project effectiveness; updates project plans, as necessary.
Ensures compliance with necessary audit requirements.
Represents Blue Cross NC in meetings with external parties including consultants, vendors, and others and may include service delivery management of vendors.
Assists with analysis and development of business processes to ensure quality, cost effectiveness, timeliness of customer service, and regulatory requirements and mandates are met.
Develops escalation process to channel issues and concerns to appropriate parties.
Pre-empts and avoid conflicts using escalation paths effectively.
Evaluates program risks, developing contingency plans and responding to change in risk as initiatives progress.
Develops effective business process improvement initiatives and communication plans.
Performs analytic functions and coaches others in analytical production, technical and other areas.
Proposes a variety of solutions to business issues/problems utilizing appropriate analysis tools (i.e., Cost/Benefit Analysis, Flowcharting, etc.).
Documents and presents program management results through the development of criteria, issue analysis papers and reports; ensures that projects established objectives such as financial goals, where applicable and creates an evaluation plan to assess project performance in relation to stated goals.
Develops and tracks budgets, operating plans, and financial cost forecasts to support the program's objectives.
Provides indirect reports, if applicable, with well-defined expectations, ongoing feedback, coaching/ mentoring and/or training.
Qualification
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Required
Bachelor's degree or advanced degree.
5+ years of experience in related field.
In lieu of degree, 7+ years of experience in related field.
Direct experience leading and implementing pharmacy programs.
The ideal candidate will have extensive experience with PBMs.
Company
Blue Cross NC
It's an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we're leading the way.
5,001-10,000 employees
H1B Sponsorship
Blue Cross NC has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2023 (2)
2022 (5)
2021 (7)
2020 (11)
Funding
Current Stage
Late StageLeadership Team
Priscilla Alfaro
VP- Payment Integrity
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