Senior Market Operations Specialist
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Job no: 495713
Recruiter: Allison Plummer
Hiring Manager: Steve Konnath
Salary Grade: I-8
Work type: Regular
Location: Omaha, Nebraska, Lincoln, Nebraska, Columbus, NE, Kearney, Nebraska, Norfolk, NE, North Platte, NE, Scottsbluff, Nebraska, Nebraska, United States, Austin, TX, Des Moines, Iowa, Denver, CO, Kansas City, Missouri, Minneapolis, MN
Categories: Administration, Leadership, Project Management
Blue Cross and Blue Shield of Nebraska (BCBSNE) is more than just an insurance company; we exist to be there for people in the best and hardest moments of their lives.
Our team is the power behind that promise. And, as the industry rapidly evolves and we seek ways to optimize business processes and customer experiences, there’s no greater time for forward-thinking professionals like you to join us in delivering on it!
As a member of Team Blue, you’ll find purpose, opportunities and the support you need to build a meaningful career and make a powerful impact in our community.
BCBSNE is happy to offer four work designations for our Omaha area employees: 100% in-office, Hybrid options, and 100% remote. If choosing to work remote, this role can be located in one of the following states: Colorado, Florida, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and Texas.
- Manages internal and external cross functional workgroups and projects that support all functions of delivering successful results to the Medicare Advantage/product line (annual bid application, product development/updates, member communications, internal/external training, development & maintenance of operational policies, identifying issues and problem solving on all aspects of the Medicare Advantage Program, etc.) and the overall senior product line of business.
- Provide oversight and analytical decision making to ensure various Medicare Advantage programs are administered and interpreted in strict conformity with corporate and government policies. Assist Medicare Advantage Compliance officer with CMS requests and audit functions.
- Participates on various committees to represent the Senior product line of business both internally from an operations standpoint as well as externally from a strategic and vendor partnership standpoint. Manages day to day external relationships with external vendor partnerships. Provides oversight and coordination of audit functions of external vendor relationships
- Prepare, analyze, track and maintain Medicare Advantage data and reports required to support the business operations
To be considered for this position, you must have:
- Bachelor’s Degree in a related field
- Five (5) years’ experience in operations leading cross-functional workgroups for a Health Insurance company and Medicare product experience.
The strongest candidates for this position will also possess:
- Five (5) years’ experience in Medicare Advantage Operations or product and/or Medicare compliance
Learn more about what makes BCBSNE such an exceptional place to work by visiting NebraskaBlue.com/Careers.
We strongly believe that diversity of experience, perspective and background will lead to a better workplace for our employees and a better product for our customers and members.
Blue Cross and Blue Shield of Nebraska is an Equal Opportunity /Affirmative Action Employer - Minorities/Females/Disabled/Veterans
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