Additional Locations:

　　Full Time Remote - Alabama, Full Time Remote - Alabama, Full Time Remote - Arizona, Full Time Remote - Arkansas, Full Time Remote - Colorado, Full Time Remote - Florida, Full Time Remote - Georgia, Full Time Remote - Idaho, Full Time Remote - Indiana, Full Time Remote - Iowa, Full Time Remote - Kansas, Full Time Remote - Kentucky, Full Time Remote - Louisiana, Full Time Remote - Maryland, Full Time Remote - Michigan, Full Time Remote - Mississippi, Full Time Remote - Missouri, Full Time Remote - Ohio, Full Time Remote - Oklahoma, Full Time Remote - Pennsylvania, Full Time Remote - South Carolina, Full Time Remote - South Dakota, Full Time Remote - Tennessee, Full Time Remote - Texas, Full Time Remote - Utah {+ 2 more}

　　Job Description

　　As a Project/Program Manager you will be supporting the Dual Eligible Special Needs Plan (D-SNP) program and/or associated programs focusing on Model of Care. In this role, you will provide full D-SNP Model of Care program management including needs analysis, program maintenance, administration and monitoring, data analysis, program evaluation, and vendor/contract administration if applicable. You will also make recommendations for changes or modifications for assigned program and implement as needed. Your work will also include assessing needs and coordinating resources to enhance existing programs.

　　What You’ll Do

　　Support segment-wide strategic alignment of clinical initiatives and identifying opportunities to enhance capabilities to manage clinically and socially complex dual eligible population

　　Support/administer D-SNP program or a phase of associated programs to ensure that prescribed activities are carried out in accordance with program objectives.

　　Align efforts so initiatives to support for STARs strategy execution, provider engagement, medical expense initiative results, member engagement, accurate risk coding, network, SDOH, and pharmacy

　　Support growth and financial goals of the D-SNP segment

　　Assess needs and coordinate resources to enhance existing programs.

　　Monitor the progress of Model of Care components to ensure the overall goals, schedules, and benefits of the Model of Care are met.

　　Document and present program results through operational reports, outcomes studies, presentations, and publications. Prepare program reports for superiors.

　　Recommend and/or implement program and process changes as needed to achieve program goals and objectives.

　　May have budget responsibilities to control expenditures in accordance with budget allocations, together with the conformance to timing, limits and usage of funding as agreed upon in the spending plan for the assigned program.

　　May handle vendor management and administer program contracts to ensure vendors meet service level agreements if applicable.

　　What You Bring

　　Bachelor's degree or advanced degree (where required)

　　3+ years of experience in related field.

　　In lieu of degree, 5+ years of experience in related field.

　　What We Like

　　Background in clinical operations, preferred

　　2+ years DSNP experience

　　Experience in population health, care management, clinical review or coding, or utilization management in a health care organization/system or health insurance

　　If you’re ready to make a career out of making a difference, this is the opportunity for you.

　　We invite you to check out our careers site to see we value diversity and inclusion at all levels of our organization. We have inclusion challenges throughout the year and affinity groups that are an integral part of our culture!

　　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. We offer more than health insurance our customers can count on. We’re committed to better health and better health care − in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well-being of North Carolinians.

　　Blue Cross NC is a fully taxed, not-for-profit North Carolina company with major operations centers in Durham and Winston-Salem. We employ more than 5,000 people who are passionate about health care, and we serve more than 4.3 million members.

　　Help us lead the charge for better health care by joining our award-winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives.

　　E-Verify

　　Our company uses E-Verify to confirm the employment eligibility of all newly hired employees. To learn more about E-Verify, including your rights and responsibilities, please visit E-Verify Overview (https://www.e-verify.gov/employees/e-verify-overview) for English or Visión General de E-Verify (https://www.e-verify.gov/es/empleados/vision-general-de-e-verify) for Español.

　　Third Party Staffing Agencies

　　Blue Cross NC does not accept unsolicited resumes from any source other than directly from candidates. For the protection of all parties involved in the recruiting process, resumes will only be accepted from recruiters/agencies if a signed agreement is in place at the inception of the recruiting effort and authorized for a specific position. Unsolicited resumes sent to Blue Cross NC from recruiters/agencies do not constitute any type of relationship between the recruiter/agency and Blue Cross NC and do not obligate Blue Cross NC to pay fees if we hire from those resumes.