Program Manager - Diabetes, Phoenix, AZ
Job Title Program Manager- Diabetes- prefer CDE certification -Masters degree required
Job ID 5159
Blue Cross Blue Shield of Arizona is a local, independent Blue Cross Blue Shield Association and a not-for-profit health insurance company headquartered in Phoenix. Founded in 1939, the company has more than 1,400 dedicated employees throughout its Phoenix, Tucson, Chandler and Flagstaff offices. Providing health insurance products, services and networks to more than 1 million Arizonans, Blue Cross Blue Shield of Arizona offers various health plans for individuals, families, and small and large businesses. Blue Cross Blue Shield of Arizona also offers Medicare supplement plans to individuals over age 65.
Blue Cross Blue Shield of Arizona helps to fulfill its mission of improving the quality of life of Arizonans by delivering a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
Support the Sr. Manager of Clinical Benefits Management Solutions with leading and engaging key stakeholders with the delivery and execution of the Diabetes Management Program across all business segments to ensure program interventions, goals and targeted outcomes are integrated with systems/processes.
To develop programs, track interventions, program outcomes and services to facilitate theachievement of BCBSAZ Diabetes Program goals.
- Establish Diabetes Management Program success measures/goals in partnership with Diabetes Steering Committee
- Lead the Diabetes Management Program strategic planning activities under the direction of clinical leadership and contribute to the achievement of BCBSAZ’s Make Arizona Healthier goals.
- Ensure Diabetes Management Program interventions are incorporated into policies and operational procedures and coordinate activities between multiple divisions to achieve desired results
- Identify internal and external training needs related to diabetes, diabetes management and diabetes resources and develop and facilitate internal/external Diabetes Management Program education geared towards managing improving health outcomes and the effective management of costs.
- Maintain and monitor the delivery and effectiveness of the diabetes program, identify solutions to challenges and implement improvements
- Assist with the evaluation of program performance and quality management activities as it applies to diabetes.
- Present program status reports to clinical leadership and Steering Committee
- Maintain all standards in consideration of state, federal, BCBSAZ, URAC, and other accreditation requirements.
- Participate in continuing education and current trends in Diabetes Management.
- Manage use of corporate funds including budgeting, financial management, and reporting.
- Volunteer within the community to help BCBSAZ give back to community charitable efforts.
- Ability to travel up to 25% of time to attend work related business meetings, trainings and conferences.
- The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
Perform other duties as assigned.
Required Work Experience
- years of work experience with medical terminology or in a healthcare setting
- 5 years of work experience in a managed care setting
- 2 years management/oversight of vendor contracts
- 1 year experience with pharmacy or pharmacy contract
- Masters degree in Healthcare or Business related field
Preferred Work Experience
- 5 years of experience in clinical education, training and instructional design.
- 1 year of experience working with Milliman Care Guidelines (MCG), InterQual and/or other clinical criteria/guidelines.
- Bachelor's Degree in Nursing or Master’s Degree in Nursing
- Certified Diabetes Educator (CDE)
Required Job Skills
- Strong written and verbal communications. Excellent organizational skills and strong attention to detail
- Possess proficient computer and technological skills especially Word, Excel, Powerpoint, SharePoint, Lync/Webinar and Internet
- Ability to gather, analyze data and prepare informative and accurate reports.
- Ability to understand the workflow of multiple components of the company and to assist in the creation and implementation of integrated policies, procedures, workplans and creative solutions.
Required Professional Competencies
- Ability to develop, organize, motivate, coordinate and collaborate effectively with stakeholders from multiple business areas across the organization
- Ability to successfully function in an environment characterized by risk taking, rapidly changing market conditions, strong competition and restructuring.
- Strong understanding of the costs/quality challenges of today’s health care environment.
- Knowledge of health and/or patient education and behavior change techniques
- Organizational skills to analyze, interpret data, synthesize, evaluate and explain educational concepts, practices and methodologies to staff and transfer data to and from written and verbal medium.
- Ability to maintain confidentiality and privacy
- Advanced knowledge of Adult Learning Theory principles and demonstrated ability to facilitate training that resonates with all learning styles
- Practice interpersonal and active listening skills to achieve customer satisfaction
- Demonstrated organizational skills with the ability to priortize tasks and work with multiple priorities
- Follow and accept instruction and direction
- Establish and maintain working relationships in a collaborative team environment
- Apply independent and sound judgment with good problem solving skilll
Required Leadership Experience and Competencies
- Desire and capability to drive toward and achieve high standard of quality and results.
- Mindset geared toward the creation, execution and continuous improvement of clinical benefit management department and programs.
- Intellectual curiosity and ability to view old problems/issues with a fresh perspective.
- Ability to perform job role duties independently.
- Ability to professionally represent BCBSAZ in the community
BCBSAZ does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.