The Network Solutions Consultant is a dynamic, multifaceted role that will play a key role in understanding, supporting innovation acceleration and demonstrating best practice financial improvement activities and goals across the organization and within healthcare. Such initiatives include researching new technologies and opportunities, launching pilot programs, accelerating fit for excellence practices and technologies, and assisting with strategic partnerships.

The Network Solutions Consultant works closely with management, external customers, internal business and analytical units in support and collaboration to deliver successful major initiatives and leading subprojects for innovation acceleration activities/initiatives.

The individual has very good project management, communication, and operational skills and can identify/evaluate opportunities for optimizing new and emerging healthcare trends and emerging markets. Capable of prioritizing multiple projects simultaneously and managing deadlines as required for self and teams.

The Network Solutions Consultant wears many hats – today they may be a project coordinator, tomorrow a business analyst, process developer, process consultant, or customer interaction specialist. The most successful Network Solutions Consultant are confident, quick-thinking individuals who set high goals and even higher standards – and aren’t afraid to ask questions to get the job done right. Capable of adapting to change, learning quickly and demonstrating creative thinking skills while building positive interpersonal relationships with internal and external customers. Were focused on creating new opportunities that drive change in areas such as provider engagement, provider reimbursement strategies, quality improvement, service operations, provider and member experience.

This individual is capable of managing projects from inception through implementation, which involves quickly gaining a working knowledge of new and complex business issues; developing and utilizing detailed project management plans, tools and methodologies; building effective project teams from individuals with diverse levels of knowledge; and using creativity and initiative in providing solutions which meet or exceed established project objectives.

Proven ability to interface with customers to define business processes and business requirements; including ability to translate technical requirements and needs into a business case / user story for customers. Responsibilities include research, analysis, selection and development of appropriate solutions; planning and leading implementation of solutions; project budget, resource control, and transitioning fully implemented projects to BAU. Capable to work on multiple implementation and consulting projects simultaneously.
Innovation expert in customer’s eyes; enhances existing initiatives and network processes through a continuous feedback loop designed to optimize the impact of innovation and fit for excellence initiatives. This individual will map, create process documentation and train or coordinate training for customers or external partners. Called upon at times to test and troubleshoot operational process and functionality of installed processes; identifies and documents technical and knowledge issues to be escalated to appropriate IT and Clinical/Quality teams for response and improvements. Provides feedback report to project lead, stakeholders, and team on customer experiences for process improvement. May work directly with customers on-site or provide support remotely. Works on issues of moderate scope where analysis and evaluation of situations or data requires a review of a variety of factors. Exercises judgment within defined procedures and practices to determine appropriate action.

JOB REQUIREMENTS

Education:

• Bachelor's Degree in Business Management, Management Information Systems or equivalent related work experience.

Experience:

• A minimum of 3+ years disciplined project management experience using methodical approaches to project development and implementation. 


• Prefer a minimum of 2+ year of experience in the health care industry with knowledge of Capital BlueCross products and services.


• A minimum of three (3) years related business experience; previous positions within corporate development, strategy, clinical operations, or consulting highly desirable Experience planning, organizing, and managing major activities.


• Ability to comply with all corporate and department policies, procedures and standards. Performs other related duties and assignments as directed.


• Verbal and written communication skills with presentation experience Familiarity with healthcare industry trends, landscape and concepts highly desirable


• High level of proficiency and experience understanding of technologies such as Microsoft Office Suite. 


• Strong business acumen, analytical problem solving and process improvement with industry or consulting experience.


• Experience and comfort establishing and maintaining relationships with executives and senior client contacts; sound judgment, diplomacy, and the highest professional ethics and integrity 


• Demonstrated ability to work both creatively and analytically in a highly-collaborative environment to solve objectives
   

Leadership:

• Ability to plan, organize, lead and control projects and work teams. Includes the ability to effectively communicate in writing and verbally with technical and non-technical audiences and knowledge levels. Also includes persuasion and negotiation skills to resolve differences with skill and understanding.


• Exercises effective organization and visioning technique skills in leading and coordinating work to manage multiple mid-size projects to meet interim and final deadlines; providing clear and timely updates to management, teams, and stakeholders on project status, risks, and mitigation plans.


• Lead and coordinate work amongst team members to managing multiple tasks, and mid to large size projects, for timely achievement of interim and final goals and objectives.


• Ability to effectively delegate tasks within the bounds of the assigned project. Demonstrates basic knowledge of project management practices and techniques.


• Lead strategic projects from conception through delivery to client leadership, including identifying strategic direction of the work and directing internal team members in project-related tasks


• Ability to lead cross-functional teams, meetings and give presentations to both management, team members, and customers, including major partnership initiatives.


• Ability to interface with executives, senior management, and customers within and outside the organization. Exercises effective decision-making skills, managing all aspects of project execution, including project planning, contracting, tracking budget, scope and internal resources; communicate project progress to team members and firm leadership.


• Collaborate and exercise good interpersonal skills in leading project team members to successfully meet the projects goals and objectives by producing high-quality, visually compelling, and actionable deliverables. Includes the ability to develop teamwork among diverse groups.

Skills:

• Experienced and comfortable with leveraging tools for organizing/analyzing data to determine quantifiable outcomes in both detail and summarized format using MS Excel, PowerPoint, Word, project management software, Visio, SharePoint and other technology.


• Ability to communicate in an effective and timely manner with individuals of diverse background and knowledge, and all levels of management.


• Ability to effectively establish working relationships with individuals of diverse background, knowledge, and all levels of management.


• Ability to work collaboratively in a fast paced, dynamic team environment.


• Ability to effectively resolve conflict within established relationships.


• Ability to independently apply analytical problem-solving skills within area of expertise and solve complex problems with appropriate support.


• Skills to communicate complex ideas effectively.


• Ability to make low impact decisions not affecting the overall project with guidance and appropriate support.


• Ability to effectively acquire working knowledge of project objectives and related business issues/technology and demonstrates such knowledge and vision in dealing with project sponsors, team members, business units, and others.


• Ability to quantify and prioritize assigned assignments, the ability to adapt to changing work requirements and assignments and complete assignments independently with some direct supervision.


• Strategic problem-solving mindset. Ability to conceptualize and validate potential opportunities and proactively anticipate/address problems and roadblocks before they occur.


• Understanding key drivers of business value, leading to successful team contributions of translating business opportunities into project analytics.


• Excellent written and verbal communications skills, particularly in explaining complex analyses, insights or analytical concepts to senior executives.


• Demonstrates familiarity and experience with traditional project management practices, techniques, and methodologies and specific Capital BlueCross processes.


• Ability to develop and implement process flows.


• Pitch in wherever, whenever, and however appropriate to serve organizational, customer, and department objectives.

Knowledge:

• Demonstrates basic knowledge of project management practices and techniques.


• Demonstrates knowledge of and supports application of basic team building techniques.


• Ability to quickly gain knowledge of new business processes and issues.


• Ability to lead diverse work groups/teams to successfully meet established objectives.


• Knowledge of the health care industry and CBC corporate structure. Includes knowledge of terminology and concepts in the health insurance space, including key concepts from health reform, CBC standards, policies, and business practices and procedures for multiple departments/systems and its implications on payer-provider relationships. Is familiar with those business services, systems and/or processes provided by external business partners.

Capital BlueCross is an independent licensee of the BlueCross BlueShield Association. We are an equal opportunity/affirmative action employer and do not discriminate on the basis of race, color, religion, national origin, gender, sexual orientation, gender identity, age, genetic information, physical or mental disability, veteran status, or marital status, or any other status protected by applicable law.