Dir, Mandate Implementation

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health.  For over 90 years, we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience.  Our members are our neighbors, our friends, and our families.  It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds. 

This position is responsible for assessing and identifying the best enterprise-wide solutions for all legislative and regulatory mandates for the company. Reporting to the Director of the Mandate Program Office (MPO), EOB Governance, UAT CoE, BCBS Association Programs and GP Vendor Systems Management, this individual directs the planning and execution of all mandate projects through cross-divisional collaboration. Establishes Mandate Governance processes and ensures reporting to EVP Steering Committee. Ensures that all mandate projects provide an end-to-end solution that is optimized to leverage Horizon’s existing operations and systems. Implements federal, state and BCBSA mandates. Provides enterprise-wide oversight to ensure that Mandate portfolio is planned and implemented in accordance with standard corporate processes ensuring that senior management is made aware of any potential adverse impact upon other enterprise-funded, discretionary projects or ongoing operations.

Job Responsibilities:

• Lead efforts to collaborate with cross-enterprise leaders to proactively identify pending federal and state legislation/regulation and provide senior management with a comprehensive assessment of impact to existing business and strategy, identify and direct projects to implement new laws and regulations.
• Ensure Mandate group partners with Legal, Compliance and business owners of individual projects within program to balance project scope, benefits, budget, and resource allocations to meet overall program goals and objectives.
• Directs program manager(s) to: (1) meet annual program objectives of mandate compliance; (2) ensure overall client satisfaction and appropriate level of service delivery and project deliverables; and, (3) ensure a seamless transition of project deliverables to ongoing operations.
• Directs communication and reporting of key program management information including assessments of key risks and issues to EPMO and Senior Leadership Team. Also leads annual mandate portfolio planning process in conjunction with business, EPMO and IT leaders, including justified request for enterprise funding.
• Conducts performance reviews on an annual basis for assigned staff and responsible for hiring, promotions, performance reviews and administering salaries for assigned staff;
• Ensures assigned staff meets all regulatory requirements and comprehends and complies with best practices, professional standards, internal policies, and procedures
• Accountable for maintaining effective internal controls over the processes and transactions under areas of responsibility including the completeness and accuracy of financial information and transactions, compliance with applicable laws and regulations, and the effectiveness and efficiency of operations.

Disclaimer:
This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.

Education/Experience:

• High School Diploma/GED required
• Bachelor degree preferred or relevant experience in lieu of degree
• Requires a minimum of 5+ years of management experience.
• Requires 5+ years project management experience with working understanding of PMO structures and capabilities
• Requires experience in Healthcare with legal and regulatory compliance background

Additional licensing, certifications, registrations:

• PMI Certification desired

Skills and Abilities:

• Ability to interact and influence senior leaders of the organization
• Excellent supervisory/management skills
• Strong analytical and problem solving
• Superb conflict management and relationship management skills
• Excellent technical proficiency in project management tools
• Excellent facilitation, coaching and platform skills

Travel (If Applicable):

• Minimal

 

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware

Salary Range:

$135,900 - $185,535

​This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity.  This range has been created in good faith based on information known to Horizon at the time of posting.  Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:

• Comprehensive health benefits (Medical/Dental/Vision)

• Retirement Plans

• Generous PTO

• Incentive Plans

• Wellness Programs

• Paid Volunteer Time Off

• Tuition Reimbursement

Disclaimer:
This job summary has been designed to indicate the general nature and level of work performed by colleagues within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of colleagues assigned to this job.

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law.  Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.