Capital BlueCross is the leading health solutions and insurance company in Central Pennsylvania and the Lehigh Valley. As a partner in the community’s health for nearly 80 years, we offer health insurance products, services, and innovative technology solutions that provide peace of mind to consumers and promote health and wellness for our customers.
Headquartered in Harrisburg, Pa., this capital city offers something for everyone, including access to the outdoors, with mountains, rivers and streams close by, and shore points within a half day’s drive. Major east coast cities such as Philadelphia, New York, Baltimore, and Washington, D.C. are just a few hours away by car. The area is also bolstered by multiple colleges and universities offering top notch higher education. A lively arts scene is enjoyed in the Harrisburg area as well as a variety of family entertainment venues, including amusement parks and sports arenas that make the area an ideal location for families.
This Manager will lead the development, evolution and implementation of Capital BlueCross’s behavioral health strategy. We’re looking for a highly clinical, metrics-driven strategist to be our team’s subject matter expert, making sure our processes are aligned with industry standards relating to effectiveness of initiatives/processes, and that our behavioral health vendors are delivering effective, sound care to patients with respect to compliance, regulations and our treatment platform.
Specifically, this professional will design, manage, and monitor key performance reports including documentation for NCQA, CMS and others; ensure that vendors are meeting our members’ behavioral health treatment needs and expectations; assess and monitor the training and education of internal and external stakeholders; and design/implement improved organizational processes for the behavioral health team. This role involves leading clinical initiatives and projects, from inception to completion.
Qualified candidates will have superior cross-functional interaction and people management skills plus clinical expertise in all aspects of behavioral health and its intricacies woven throughout healthcare system operations. Must be proficient with NCQA, CMS and PA state law and mandates, very comfortable with electronic research, and possess the skills to systematically analyze problems and guide the service and documentation practices of vendors. Exceptional strategic planning skills are necessary.
Must have a Master’s degree in healthcare administration, nursing or business, 5+ years’ experience in a behavioral health clinical setting and 3+ years of management experience. Six Sigma or other professional certifications strongly preferred.
More than a health insurer, the company delivers innovative solutions through a family of diversified businesses that is creating a healthier future and lowering health care costs. Among these solutions are patient-focused care models, leading-edge data analytics, and digital health technologies.
We offer a highly competitive, market-driven compensation/benefits plan. Capital BlueCross is also committed to providing physical activity and wellness opportunities for our employees. We offer a convenient on-site fitness center, wellness incentives, and access to personal fitness training sessions to help employees meet their health goals. We have been recognized as a 2016 Platinum-Level Fit-Friendly Worksite by the American Heart Association and were named #3 on Training Magazine’s list of the top 125 globally ranked training programs.
Our innovative Capital Blue Health and Wellness Centers located in Enola and Center Valley provide in-person service and inspiration to help people reach their health goals. Each one is open to the public and includes a fitness studio, Healthy You Café and on-site care guides skilled in multiple areas, including nutrition and biometrics screening. Capital BlueCross employees can take advantage of the many services offered at Capital Blue at little to no cost.
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. We offer a highly competitive, market-driven compensation/benefits plan. Engage with us on LinkedIn, Twitter, Facebook or Instagram.
Interested and qualified candidates should apply online at www.capbluecross.com/careers.