Resp & Qualifications

PURPOSE:

The Business Consultant in Health Services provides expertise in tailored, strategic, and critical work to help design, launch, and execute programs that support initiatives in the changing healthcare environment. Define and execute the product strategy and roadmap for the CareFirst Behavioral Health portfolio, ensuring alignment with the companys strategic objectives. Develop and execute the CareFirst Behavioral Health Strategy to contract and expand solutions across all lines of business (Commercial, Institutional, Facility). Independently pursue partnership opportunities, in depth analysis of potential partnerships, negotiate contract details while simultaneously balancing and continuing to build out a robust network offering for the CareFirst members.

We are looking for an experienced professional in the greater Baltimore/Washington metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week from home and a portion of their week at a CareFirst location based on business needs and work activities/deliverables that week.

Essential Functions

Provides strategic planning, business plan, and roadmap for CareFirst Behavioral Health programs. Identifies market needs. Identify, analyze, negotiate, and implement strategic behavioral health partnerships. Respond to RFPs and contracting requirements to identify new opportunities and understand the evolving landscape.
Manages the new and renewal contracting process for all behavioral health partnerships. Provide subject matter expertise in a particular area (including but not limited to one of the following: project management, finance and budget, human resources, data and metrics, information technology, etc.) that contributes to the effective accomplishment of initiatives tasks and goals. Collaborate on the business strategy, thesis, programs and the identification of strategic opportunities.
Support cross-functional teams and projects between division, and others to deliver value to team. Proactively identify ways, means, and platforms to build synergy and mutually reinforcing workstreams to accomplish tasks more effectively across different business functions of initiatives. Presents at monthly, quarterly meetings, JOCs, onboarding efforts, and training sessions.
Develops implementation processes and manages reporting to ensure client retention and high levels of provider satisfaction. Design and run dashboards to support clear communication across vertical components of business. Review and support task coordination while identifying potential process improvements. Develop and finalize budgets, policies, and other documentation for programs.
Collaborates with cross functional teams (clinical, cost of care, provider relations, provider operations). Build trusted relationships within CareFirst to deepen subject-matter expertise, find opportunities to synchronize with core operations, and ensure close coordination with the central team in the execution of their areas of responsibility within the division. Identifying opportunities for synergies to improve task execution across the organization.
Working collaboratively with other support partners in our current and upcoming programs. Communicating strategy, programs, and next steps to leadership and our partners. Stay informed of industry trends, best practices, and emerging technologies to inform and influence the product strategy direction. Maintain ongoing account relationships at multiple levels of the customers organization. Interact with C-Suite stakeholders.

Qualifications

Education Level: Bachelor's Degree OR In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

Experience: 5 years experience in business development, operational technology support, general business operations and/or consulting experience.

Preferred Qualifications

Behavioral Health Background
In depth knowledge of behavioral health services; adult and pediatric (SUD, BIHS, SMI, IOP, PHP)

Knowledge, Skills And Abilities (KSAs)

Understands business goals and priorities.
Follows evolving market, industry and consumer trends.
Effective communication of complex ideas both verbal and written.
Exceptional project management, facilitation and organizational skills.
Excellent relationship management skills.
Strategic thinker, problem solver, and a collaborator who can drive engagement and discussions.
Significant experience with MS Office (Excel, PowerPoint, Word).
Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Salary Range: $87,480 - $173,745

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilites of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Department

Provider Contracting Administration

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Where To Apply

Please visit our website to apply: www.carefirst.com/careers

Federal Disc/Physical Demand

Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on health care programs.

Physical Demands

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship.

CareFirst BlueCross BlueShield

Latest Jobs

Behavioral Health Business Consultant (Hybrid)