Responsibilities include but are not limited to:
Creating bid (RFP) structures for each category based on strategic direction for Genetic CAG and Plans.
Administering RFPs.
Ensuring participating Plans meet contractual requirements including utilization management and other medical management and contractual obligations.
Analyzing contract offers, including interpreting requirements and caveats and forecasting yields and ROI.
Supporting contract negotiations under the guidance of the Managing Dir. as appropriate and independently negotiates agreements assigned along with small amendments and large amendments.
Able to effectively manage employees including their career development, compliance with BCSBA Policy and performance management.
Interacts with Lab/Precision Medicine companies, participating Plans, internal BCBSA Stakeholders and team to coordinate maintenance and growth of BCBSA Lab/Precision Medicine category.
Responsible for the coordination and management of Genetic CAG Workgroup responsibilities as assigned and in collaboration with OCA.
Ensures stakeholder engagement (suppliers and Plans) via calls/webinars, supplier launches, supplier ongoing engagement business reviews and Plan engagement, annual conference.
Responsible for operations, people/project management, technical strategic direction and delivery of division/department initiatives of one or more Practice areas. Maintains ownership of specific high-profile functions/set of services.
Grows the category assigned both through the addition of new national agreements, agreement expansion and Plan adoption/utilization. Responsible for the day-to-day management of contracts assigned. Has the ability to acquire, organize and synthesize financial data and other information to identify and communicate key findings. Maintains financial viability and takes ownership of category.
Leads by example showing commitment to BCBSA values creating an excellent work environment for employees and positive morale of the department division and company.
Makes recommendations to the Managing Director and engages team in the development of long term pipeline of opportunities to explore within assigned categories.
Required Education, Certifications and Experience
Bachelor's degree in any business discipline (e,g, Finance, Economics, Marketing, Business Administration), scientific areas (e.g. biology, chemistry, pre-med) or liberal studies.
A minimum of five years related business experience in complex contract negotiations. experience or technical discipline within the Lab/Precision Medicine or provider ancillary contracting and/or healthcare, hospital industry and interest in scientific categories.
Demonstrated project management and team leadership experience.
Demonstrated knowledge of lines of business (Commercial, Medicare Advantage, Medicaid) and pursuant to federal and state regulations, as applicable.
Demonstrated ability to work independently and take ownership of categories assigned.
Strong oral/written communication and presentation skills.
Strong relationship management skills.
Strong analytical skills.
Proficiency on Microsoft office products (Word, Excel, Power Point).
Preferred Education, Certifications and Experience
Master's Degree.
Eight years' experience in complex contract negotiations, experience or a technical disciple within the Lab/Precision Medicine or provider ancillary contracting and or healthcare or hospital industry and interest in scientific categories.
People Management
Yes