Blue Cross Blue Shield Association
Senior Director, Care Delivery
Blue Cross Blue Shield Association, Washington, District of Columbia, us, 20022
Join to apply for the
Senior Director, Care Delivery
role at
Blue Cross Blue Shield Association Join to apply for the
Senior Director, Care Delivery
role at
Blue Cross Blue Shield Association Get AI-powered advice on this job and more exclusive features. The Hiring Range For This Role Is
$172,326.41 - $282,228.46
This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the hiring range and this hiring range may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs. This job is also eligible for
annual bonus incentive
pay.
We offer a comprehensive package of benefits
including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits
to eligible employees.
Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
Job Description Summary
Provides strategic leadership and innovative practices for the Federal Employee Program, aiming to reduce care delivery costs while improving quality metrics. Oversees FEP's medical/surgical benefit management, including value-based care, case and disease management, and mental health services. Advises stakeholders, enhancing plan engagement, and promoting health equity. This role focuses on developing clinical programs, analyzing health outcomes, managing population health, and fostering a culture of excellence, teamwork, and continuous learning. Additionally, it includes mentoring staff to build a positive, collaborative work environment.
Responsibilities Include But Are Not Limited To
Direct the creation and development of case and disease management strategies, mental/behavioral health programs, utilization management, and medical-surgical coding to boost engagement, outcomes, and operational efficiency; ensure uniform program delivery nationwide, work on cost containment, and promote health equity; guide cross-functional teams to execute clinical initiatives and streamline claims and invoice processing. 30% Collaborates cross-functionally to launch equity initiatives, develop programs, recommend system changes, and create performance metrics; ensures alignment across delivery systems for new clinical products and services; oversees administration, compliance, and stakeholder readiness for complex benefits and clinical programs. 25% Provides leadership and expertise for FEP and BCBSA initiatives, guides innovative clinical and quality health outcomes initiatives, ensures consistent delivery of clinical services across vendors, and represents clinical interests in benefit proposal negotiations with the Office of Personnel Management. 25% Lead and manage a team with the aim of driving effective performance management, fostering professional growth, and creating a positive and inclusive work environment. This role is dedicated to utilizing strong leadership and communication skills to motivate and inspire team members, ensuring they are aligned with and committed to achieving the organization’s goals. 20%
Education
Required Education, Certifications and Experience:
Required Bachelor's Degree in allied Health, Pharmacy or Business or equivalent work experience. Clinical degree a plus (RN, MSN, RPH, PharmD, MD, LPN)
Experience
12+ Years health Plan experience (or equivalent clinical experience) Required
Knowledge Skills And Abilities
Technical proficiency with information technologies (e.g. Microsoft Office) Experience rolling out new programs and operational experience in managing programs and budgets Understanding of health care/managed care industry and environment including health care issues, reform, competition, ancillary provider trends and MCO industry trends Excellent interpersonal skills and ability to work with and within a cross-functional team environment Ability to work within all levels of organizational and government and vendors Excellent verbal, presentation and written skills as well as the ability to establish and manage multiple priorities The ability to gain various viewpoints and arrive at critical decisions to ultimately develop and implement strategic initiatives Proven ability to lead motivate and organize teams and knowledge Technical proficiency with information technologies (e.g. Microsoft applications, Winframe, account management and group ware) to enable the management of on-going communication
Additional Information
Minimum of 12+ years’ Health Plan experience (or equivalent clinical experience)
Seniority level
Seniority level Director Employment type
Employment type Full-time Job function
Job function Health Care Provider Industries Insurance Referrals increase your chances of interviewing at Blue Cross Blue Shield Association by 2x Sign in to set job alerts for “Director of Care” roles.
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Senior Director, Care Delivery
role at
Blue Cross Blue Shield Association Join to apply for the
Senior Director, Care Delivery
role at
Blue Cross Blue Shield Association Get AI-powered advice on this job and more exclusive features. The Hiring Range For This Role Is
$172,326.41 - $282,228.46
This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the hiring range and this hiring range may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs. This job is also eligible for
annual bonus incentive
pay.
We offer a comprehensive package of benefits
including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits
to eligible employees.
Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
Job Description Summary
Provides strategic leadership and innovative practices for the Federal Employee Program, aiming to reduce care delivery costs while improving quality metrics. Oversees FEP's medical/surgical benefit management, including value-based care, case and disease management, and mental health services. Advises stakeholders, enhancing plan engagement, and promoting health equity. This role focuses on developing clinical programs, analyzing health outcomes, managing population health, and fostering a culture of excellence, teamwork, and continuous learning. Additionally, it includes mentoring staff to build a positive, collaborative work environment.
Responsibilities Include But Are Not Limited To
Direct the creation and development of case and disease management strategies, mental/behavioral health programs, utilization management, and medical-surgical coding to boost engagement, outcomes, and operational efficiency; ensure uniform program delivery nationwide, work on cost containment, and promote health equity; guide cross-functional teams to execute clinical initiatives and streamline claims and invoice processing. 30% Collaborates cross-functionally to launch equity initiatives, develop programs, recommend system changes, and create performance metrics; ensures alignment across delivery systems for new clinical products and services; oversees administration, compliance, and stakeholder readiness for complex benefits and clinical programs. 25% Provides leadership and expertise for FEP and BCBSA initiatives, guides innovative clinical and quality health outcomes initiatives, ensures consistent delivery of clinical services across vendors, and represents clinical interests in benefit proposal negotiations with the Office of Personnel Management. 25% Lead and manage a team with the aim of driving effective performance management, fostering professional growth, and creating a positive and inclusive work environment. This role is dedicated to utilizing strong leadership and communication skills to motivate and inspire team members, ensuring they are aligned with and committed to achieving the organization’s goals. 20%
Education
Required Education, Certifications and Experience:
Required Bachelor's Degree in allied Health, Pharmacy or Business or equivalent work experience. Clinical degree a plus (RN, MSN, RPH, PharmD, MD, LPN)
Experience
12+ Years health Plan experience (or equivalent clinical experience) Required
Knowledge Skills And Abilities
Technical proficiency with information technologies (e.g. Microsoft Office) Experience rolling out new programs and operational experience in managing programs and budgets Understanding of health care/managed care industry and environment including health care issues, reform, competition, ancillary provider trends and MCO industry trends Excellent interpersonal skills and ability to work with and within a cross-functional team environment Ability to work within all levels of organizational and government and vendors Excellent verbal, presentation and written skills as well as the ability to establish and manage multiple priorities The ability to gain various viewpoints and arrive at critical decisions to ultimately develop and implement strategic initiatives Proven ability to lead motivate and organize teams and knowledge Technical proficiency with information technologies (e.g. Microsoft applications, Winframe, account management and group ware) to enable the management of on-going communication
Additional Information
Minimum of 12+ years’ Health Plan experience (or equivalent clinical experience)
Seniority level
Seniority level Director Employment type
Employment type Full-time Job function
Job function Health Care Provider Industries Insurance Referrals increase your chances of interviewing at Blue Cross Blue Shield Association by 2x Sign in to set job alerts for “Director of Care” roles.
Washington, DC $85,404.80-$142,334.40 2 weeks ago Operations Manager - Hospital Based Services (HBS)
Washington, DC $85,404.80-$142,334.40 3 weeks ago District of Columbia, United States $179,000.00-$298,000.00 1 week ago District of Columbia, United States $85,000.00-$95,000.00 2 months ago Washington, DC $64,771.00-$80,964.00 8 months ago Washington, DC $65,000.00-$75,000.00 4 weeks ago Director of Revenue Cycle Behavioral Health Service Line
Washington, DC $110,000.00-$125,000.00 2 weeks ago Director of Clinical Services - Behavioral Health
District of Columbia, United States 4 weeks ago Washington, DC $200,000.00-$225,000.00 1 month ago Washington, DC $85,000.00-$95,000.00 2 months ago Washington, DC $125,000.00-$145,000.00 5 days ago Washington, DC $137,550.40-$229,257.60 2 weeks ago Washington, DC $114,746.00-$129,090.00 1 month ago Washington, DC $175,000.00-$250,000.00 5 days ago Washington, DC $126,000.00-$157,500.00 19 hours ago Washington, DC $145,000.00-$165,000.00 1 week ago District of Columbia, United States $130,000.00-$180,000.00 1 week ago Medical Director - Post-Acute Care Management - Care Transitions - Remote anywhere in US
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Director of Professional Development & Education
DowntownDC Business Improvement District (BID) - Director of Homeless Services
Washington, DC $100,000.00-$125,000.00 2 weeks ago We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.
#J-18808-Ljbffr