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Job Description

We are seeking a dynamic leader to drive excellence in provider, member, and business partner interactions while fostering strong, productive relationships. This role partners with stakeholder leadership to shape business strategies that support operational efficiency and deliver an exceptional member experience.

As the Manager, Contact Center, you will provide vision, direction, and leadership to a high-performing, customer-facing team. You will oversee strategic functions that ensure compliance with state, federal, and BCBSA standards, while empowering team members to achieve peak performance. Success in this role requires building collaborative relationships across the organization and inspiring a culture of accountability, innovation, and service.

What** **You’ll** **Do

People Management

+ Develop performance goals and track performance against established goals.  Handle complex employee issues.

+ Conduct random audits ofteamswork.

+ Review audit results with staff and create performance improvementplansas necessary.

+ Develop and implement training plans to ensure growth and development for staff.

+ Develop staff providerrelationskills and provider communication through formal and informal training, coaching, and feedback.

+ Interpret and analyze complex data from staffing models and other sources toidentifyissues and make recommendations for effective solutions.

+ Develop resource allocation strategies to meet changing business demands.

Stakeholder Engagement

+ Represent BCBSNC in stakeholder meetings to address stakeholder inefficiencies and to ensure contractual compliance.

+ Plan all on-site visits to stakeholders toeducateonBCBSNC medical or administrative policies and procedures.

+ Address stakeholder concerns and non-compliance contract/administrative issues. Coordinate the required corrective actions.

+ Partner with assigned stakeholders to understand their processes,proceduresand systems as they relate to the way they conduct business with BCBSNC.

+ Develop andmaintainextensive knowledge of key stakeholders and/or regional territories.

+ Leverage knowledge base toforwardEnterprise relationships with stakeholders.

+ Track stakeholder issues for root-cause analysis, escalation, and closure.

+ Document issue resolution using issue resolution protocol.

+ Comply withstate, federal and BCBSA regulations governing stakeholders andsuggestsimplementation of any product, process, or system modifications to ensure compliance.

+ Identifyopportunities to control medicalexpenseand deploy action plans toaccomplishstakeholder-specific or regional medical expense goals.

+ Participate in negotiations with stakeholders as needed.

Project/Program and Operations Support

+ Manageday-to-dayconsultative activities for ahigh-profilehealthcare system.

+ Participate in and support negotiations as needed.

+ Assistin the analysis of all products,identifyanydeficienciesand make recommendations for improvement.

+ Provide analysis and feedback for technologies, trends, bestpracticesand service offerings to incorporate them into overall stakeholder business solutions.

+ Lead team of onsite coordinators inidentifying, analyzing, and resolving complex operational issuesimpactingthe healthcare system.

+ Act astechnicalresource for the teamproviding assistanceon systemissues, work processes, and procedures.

+ Represent the department on corporate projects that require independent, sound decision making andbroad-basedunderstanding of the effects on thedepartment as a whole.

+ Develop and recommendshort- and long-termserviceobjectivesandmethods,implement these methods when approved.

+ Respond quickly and accurately toescalatedissues from clients and customers. Review customer needs and delivery commitments and review with team members.

+ Identify,analyzeand resolve complex high dollar operational issuesimpactingthe healthcare system theyare responsible foror the members and groups that they serve. Use theappropriate StakeholderService Model to increase customer satisfaction and reduce administrative costs.

What You Bring

+ Bachelor's degree or advanced degree (whererequired)

+ 8+ years of experience in relatedfield.

+ In lieu of degree, 10+ years of experience in related field

+ LEAN certification advanced within 12 months of hire.

Bonus Points

+ Experience inproviderinteractions with institutional,professionaland ancillary providers.

+ Experience in claims, customer service, membership,enrollmentor a call center environment.

+ Experience managing a project

+ Ability to interpret policy provisions

+ Make sound and independent business decisions in high pressure situations

+ Excellent interpersonal and relationship building skills

+ Strong data analysis andproblem-solvingskills

+ Knowledge of institutional and ancillary pricing, health care finance,hospitaland ancillary payments

+ Strong negotiation skills

+ Ability to effectively manage multiple high priority andhigh-profiletasks/provider relationships

What** **You’ll** **Get

+ The opportunity to work at thecutting edgeof health care delivery with a teamthat’sdeeply invested in the community.

+ Work-life balance, flexibility, and the autonomy to dogreat work.

+ Medical, dental, and vision coverage along withnumeroushealth and wellness programs.

+ Parental leave and support plus adoption and surrogacyassistance.

+ Career development programs and tuition reimbursement for continued education.

+ 401k match including an annual company contribution

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

_*Based on annual corporate goal achievement and individual performance._

$73,698.00 - $117,917.00

Skills

Action Planning, Business, Business Strategies, Coaching, Customer Satisfaction, Decision Making, Leadership, People Management, Performance Improvements, Problem Resolution, Problem Solving, Relationship Building

About Us

It's an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we're leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care − in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well-being of North Carolinians.

Blue Cross NC is a fully taxed, not-for-profit company headquartered in Durham, North Carolina. We serve more than 4.3 million members, and we employ more than 5,000 people across the country who are passionate about making health care better for all.

Help us lead the charge for better health care by joining our award-winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives.

Authorization to Work in the United States

We use E-verify to confirm authorization to work in the United States. To learn more about E-Verify, including your rights and responsibilities, please visit E-Verify Overview (https://www.e-verify.gov/employees/e-verify-overview) for English or Visión General de E-Verify (https://www.e-verify.gov/es/empleados/vision-general-de-e-verify) for Español.

Request Accommodations

Blue Cross NC provides reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application or hiring process, please notify HR at [email protected] .

For most roles, you can choose where to work - fully remote in one of the states listed below, in the office, or a hybrid of the two:

Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming