Blue Cross Blue Shield of Michigan Health Care Manager - Customer Consulting in Detroit, Michigan
Responsible for identification, analysis, and presentation of healthcare claims data to internal and external customers. Based on the analysis of the data, the department provides program and product recommendations to support prospective business decisions. The department will deliver information, knowledge, and decision making analyses to support customer expectations for responsive and solution-oriented analytics to help customers contain their healthcare costs while providing the best quality care for their members. The department presents analytics and trend data to customers in a consultative, solution-focused way. Manager would be assigned to customers and act as a health plan consultant guiding customers in their decision-making regarding BCBSM programs and/ or products. The department provides annual customer evaluations, quarterly presentations, monthly presentations, and deeper-dive analytics to support customer decisions.
- Utilize data analytics and extensive business knowledge to manage the research, analysis, identification and evaluation of data from identified problems to evaluate existing and potential trends, competition, and issues.
- Possess and maintain in-depth knowledge of BCBSM business, products, programs (including claims, reimbursement, benefits, provider and program data, networks, etc.), corporate organizational structure (including functional responsibilities), and complex research principles/methodologies.
- Lead and monitor multidisciplinary corporate programs/projects simultaneously by managing the establishment of project plans and objectives to ensure goal attainment within defined parameters. Develop solutions to complex issues and present recommendations to senior management as well as employees at various corporate levels.
- Act as a Health Care Consultant by developing strategies and programs to reduce health care benefit costs and improve quality of care.
- Collaborate with appropriate business areas to implement proposed solutions and manage programs to evaluate effectiveness and results.
- Ensure programs and initiatives encompass broad corporate scope and present significant variables.
- Anticipate, identify, and resolve challenges in order to fulfill key corporate objectives and respond to the demand of change management and initiate actions needed to plan, organize and control team activities.
- Independently develop and plan, reports, papers and/or other materials.
- May have direct supervisory responsibility which includes performance reviews.
- Other duties may be assigned.
- Bachelor's Degree in Business Administration, Economics, Health Care, Information Systems, Statistics or other related field is required. Master's Degree in related field preferred.
- Seven (7) to Ten (10) years experience of related experience, typically in two (2) subject areas (e.g. financial analysis, planning, health care economics, health care policy, statistical modeling, business decisions, analysis, or business management).
- Excellent analytical, planning, problem solving, verbal and written skills to communicate complex ideas.
- Excellent knowledge and use of existing software packages (PowerPoint, Excel, Word, etc.).
- Ability to work independently, within a team environment and communicate effectively with employees at all levels.
- Other related skills and/or abilities may be required to perform this job.
- Strong health care background preferred.
- Health plan benefits consulting experience is a plus.
- Experience presenting to external customers required.
All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.
Job: Physician Consultant
Primary Location: Detroit
Organization: Clinical Strategies HPB-4130
Req ID: CUS000AN