Job Summary:The position will have chief oversight, coordination and implementation responsibility for all Vendor Delegation related activities and efforts. The scope of responsibility is directly linked to annualized Medical Cost savings of $20M +/ year for our insured book of business. The position is accountable for vetting, business case development, gaining approval and implementation of all large scale vendor delegation activities.

Responsibilities:
- Partner with Senior Management and the Medical Cost Interdisciplinary Council in the development of business cases to vet and support strategic partnerships for delegated programs.
- Accountable for the development of project charters, define deliverables, and structure project work plans.
- Lead communication of enterprise wide implementation findings and results to key stakeholders, including Directors and VPs.
- Identify and track risks; develop, socialize and ensure implementation of appropriate contingency plans.
- Escalate issues to Senior Leadership, including solution options that need to be considered by an executive-level audience.
- Assist Director in providing updates and information across organization.
- Manage ongoing relationship with select delegated vendors and implement expansion efforts with existing vendor partners.
- Manage, develop and train staff; develop and monitor goals; conduct annual performance reviews, and administers salaries for the staff.

The information above is intended to describe the general nature of the work being performed by each incumbent assigned to this position. This job description is not designed to be an exhaustive list of all responsibilities, duties, and skills required of each incumbent.

Education/Experience:
- Bachelor's degree required, post-graduate degree preferred.
- Requires 10 to 15 years of business experience.
- Requires 7 or more years of healthcare / insurance related experience.
- Prefers 5 or more years managing multiple projects simultaneously, managing staff and managing planning activities.

Knowledge:
- Must have a solid understanding of claim processing
- Must have strong organizational and analytical skills and demonstrated ability to effectively manage multiple projects at one time
- Must have strong inter-personal skills with a demonstrated ability to lead cross-divisional work teams
- Must demonstrate an understanding of the interdependences between the business, clinical and financial side of the health care business
- Must be proficient in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint, MS Project) and Lotus Notes; Should be knowledgeable in the use of intranet and internet applications:
- Requires knowledge of laws and regulations regulating insurance, HMO, hospital and physician practice.

Skills and Abilities:
- Requires ability to communicate successfully with all levels of management, including those at the highest level of the Organization
- Requires demonstrated ability to manage multiple high level projects simultaneously
- Requires ability to build strong inter- and intra- departmental relationships
- Must have effective verbal and written communication skills and demonstrate the ability to lead as well as to work well within a team
- Must demonstrate professional and ethical business practices, adherence to company standards, and a commitment to personal and professional development
- Experience in successfully leading cross-functional teams to achieve improvements
- Must have a solid understanding of claim processing including pricing and code editing
- Must have strong organizational and analytical skills and demonstrated ability to effectively manage multiple projects at one time
- Must have strong inter-personal skills with a demonstrated ability to lead cross-divisional work teams
- Must demonstrate an understanding of the interdependences between the business, clinical and financial side of the health care business
- Must be proficient in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint, MS Project) and Lotus Notes; Should be knowledgeable in the use of intranet and internet applications
- Must have a working knowledge of the impacts of mandates and legislation on overall claims processing and contracting

Travel:
- Some travel required.

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..