Reporting to the VP, Dedicated Operations, the role of the Director, Operations - ASO is critical to the success of Blue Shield of California and the ASO Operations department in realizing its goals and objectives. This individual will play a key role as part of the Operations team in delivering and collaborating on all aspects of supporting growth initiatives focusing on one of our top 3 growth areas, ASO. The Director, Operations - ASO will be responsible to drive operational results using influence and performance management strategies and tactics in a highly matrixed environment. To be successful, this individual will need to build strong relationships and cultivate collaborative trusting partnerships. This role will interact with all functional operational areas within the organization supporting the ASO line of business. Health plan operations and knowledge of regulatory requirements and environment is essential.
Responsibilities
Develops business strategies for the ASO operations team(s), which includes fully dedicated and designated resources.
Strategic and Tactical Planning for ASO Operations(Enrollment & Billing, Claims and Encounters Operations, and Sales Implementation)
Manages service levels, regulatory and financial performance of the ASO Operations teams across multiple locations
Defines and implements organizational structure to facilitate business performance. Ensure optimization of resources by resolving any duplicative improvement efforts and organization structures"
Accountable to drive end to end ASO dedicated model which includes writing executive summaries, dashboard reporting, and working with key business owners to execute.
Responsible for evolving the ASO model by identifying opportunities for growth and future evolution
Demonstrates and exemplifies BSC Leadership Behaviors and drives the behaviors throughout their team(s), department(s), or functional area.
Fosters a great place to work by clearly defining mission, vision, goals, roles, and expectations for team members; recognizing top talent and team achievements; building successful working relationships across the organization; ensuring a safe and healthy work environment; delivering the tools, time, and talent needed to succeed.
Provides executive oversight and leadership to Managers responsible for creating and driving implementation of operating plans, which are required to support immediate and long-term business strategies.
Defines and establishes key performance indicators and inter-company service level agreements which are reflective of and measure Blue Shield of California's competitive position relative to service delivery.
Leads relationship management with cross-functional leaders across the enterprise, and manages cross-functional operational linkages to ensure end to end business processes surrounding operational areas meet customer and stakeholder requirements
Guides and develops near-term operating plans (annual) for designated area of responsibility.
Defines and implements organizational structure to facilitate effective delivery of operations.
Ensures that performance objectives and outcomes are consistent with external and internal customer expectations and meet competitive benchmarks; routinely integrates customer feedback and competitive information into ongoing planning and operational activities.
Develops appropriate relationships and drives coordination process to ensure business and operational linkage with business unit goals and objectives, ensuring satisfactory capacity and quality/production support will be available to meet these goals.
Defines, tracks, and manages key performance metrics for operations management.
Knowledge & Experience
Minimum of 10-12 years of relevant experience including 6 years of management experience
Bachelor's degree required; Master's degree preferred or equivalent level of education and relevant experience
Must have a minimum of 5-years health plan operational experience
5 years ASO experience
Must have a working understanding of health plan regulatory requirements
Exceptional verbal and written communication skills, including an ability to communicate effectively at an executive level
Strategic thinker who has an eye for detail, is organized
Excellent influence and engagement skills in building alignment and accountability
Ability to build strong and sustainable relationships and the capability to interact within all levels of the organization
Ability to work cooperatively and strategically in a team environment with all levels of professional, technical and administrative staff and to integrate resources on a timely and organized basis
Acumen to handle complex situations and multiple responsibilities simultaneously with the urgency of immediate demands on the operations
Ability to present information clearly and concisely to various audiences
Executive leadership, communication, and influence
Systems Thinking and End to End Thinking
Market Strategy and Competitive Road Map Experience
Additional Information
About Company: At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California has been dedicated to transforming health care by making it more accessible, cost-effective, and customer-centric. We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 6,800 employees, more than $20 billion in annual revenue and 4.3 million members. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. We're excited to share Blue Shield of California has received awards and recognition for - LGBT diversity, quality improvement, most influential women in corporate America, Bay Area's top companies in volunteering & giving, and one of the world's most ethical companies. Here at Blue Shield of California, we're striving to make a positive change across our industry and the communities we live in - Join us!
Physical Requirements: Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day. Please click here for further physical requirement detail.
EEO Footer: External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.
