Blue Cross and Blue Shield of Louisiana Jobs

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Blue Cross and Blue Shield of Louisiana Senior Business Process Engineer in Baton Rouge, Louisiana

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.

Residency in or relocation to Louisiana is preferred for all positions.

POSITION PURPOSE

This SR Business Process Engineer is responsible for working within the Benefit Operations and/or Provider Network Division. Their responsibilities include focusing on the development, identifying, analyzing and improving existing general business processes (ie.e., back-end processes not related to manufacturing) including: applying process definition, improvement and design methodologies to identify, analyze and improve business processes to improve quality, reduce costs, increase efficiencies/productivity, increase customer satisfaction, etc. Developing documentation to support analysis and improvement including business requirements, functional specifications, process maps, gap/problem analysis, etc. Planning implementing quality assurance and compliance processes. In some organizations may include supporting development of training and/or change management materials and activities to support new processes and procedures includes Six Sigma/Lean/Kaizen practitioners working in a non-manufacturing environment. Additionally, they are responsible for identifying standards to fulfill the quality requirements for service, or a product. Activities may include auditing, monitoring, and determining the quality of processes or outputs, either against defined internal or regulatory standards; reporting on process deviations and defects; identifying and developing outsourcing vendors and suppliers according to organization quality standards and policies. Promoting and sharing best practices that sustain business process improvements across the organization. The majority of the time is spent overseeing the design, implementation or delivery of processes, programs and policies using specialized knowledge and skills typically acquired through advanced education. .

NATURE AND SCOPE

  • This role typically is not responsible for managing people; however, leading change in challenging times and understanding change management processes is key.

  • This role reports to this job: DIRECTOR, Divisional Change and Operational Readiness; and the Director of Workforce Management

  • Necessary Contacts: To do this job effectively the incumbent has to be in contact with:VP & SVP Benefits Administration, Provider Network Division staff, Provider Management team members, Actuarial staff, Information Technology staff, Healthcare System Quality staff, BCBSLA Management including the Senior Management Team, Enterprise Risk Management Committee, Compliance Office, Marketing Division, Internal Audit Division, Project Management Office, Legal Division and all areas of BCBSLA as part of company-wide teams.

QUALIFICATIONS

Education

  • Bachelor's in Accounting, finance or related field is required

  • Master's in MBA is preferred

  • Four years of related experience can be used in lieu of a Bachelor’s degree.

Work Experience

  • 4 years in business process management, Six Sigma/Lean/Kaizen process simulation and solutions recommendation is required

Skills and Abilities

  • Must be detailed oriented with the ability to assess processes for efficiency and effectiveness.

  • Ability to analyze financial, legal, legislative and operational information for reporting and/or decision-making by Senior Management.

  • Must demonstrate the ability to analyze and interpret complex documents to draw valid conclusions defining and resolving operational issues.

  • Must be able to work independently, as well as be part of a team.

  • Must demonstrate the ability to work with Information Technology and processes to identify alternative processes and methodologies.

  • Excellent analytical skills required in the development of business cases.

  • Excellent written and spoken communication skills with the ability to interact with individuals.

  • Must have the ability to effectively communicate both in writing and in speaking. Presentation skills are required in order to effectively organize, develop and present objective information to all levels of employees.

  • Must have demonstrated proficiency with business reporting tools including Microsoft Office Suite; Word, Excel, Access and MS Project. Experience with process flow software is preferred

  • Must demonstrate working knowledge of project management principles and process improvement methodologies.

Licenses and Certifications

  • None Required

ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS

  • Assists the management of Benefit Operations Division Membership and Billing in providing data to ensure timely, accurate, and efficient service to our members, group leaders, providers and consultants, including representing the company on internal and external opportunities regarding but not limited to legislative mandate compliance, plan metric analysis, scorecard interpretation, business process improvement and analysis.

  • Leads analysis and strategic initiatives within the Department to proactively identify and promote opportunities for operational and financial improvement.

  • Leads projects to ensure continuous process improvement in the Department.

  • Provides support and collaboration with leaders and teams in order to address front line operational issues with members, providers, group leaders, etc.

  • Works with the Department to identify process gaps and risks to develop risk mitigation plans to help facilitate management decision-making and/or limit company liability.

  • Analyzes and recommends design of business and system processes and functionality.

  • Assists the Department to ascertain and comply with the Blue Cross Association’s goals and regulations.

  • Interprets and develops plans to operationalize complex regulations, such as health care reform, in order to help the company, maintain compliance while meeting the needs of customers, providers, group leaders, etc.

  • Works with key stakeholders for Legal, Compliance, Actuarial, and Finance to ensure all processes are completed within the proper context, laws, processes, and budgets.

  • Develops and presents information on ROI and pro forma including the requirement documents and outcome predictions to Operational Leadership and/or Senior Management to help facilitate decision-making.

  • Provides reports, production support, maintenance, problem resolution and change control functions as needed to support and enhance daily system operations for customers and management.

Additional Accountabilities and Essential Functions

The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions

  • Perform other job-related duties as assigned, within your scope of responsibilities.

  • Job duties are performed in a normal and clean office environment with normal noise levels.

  • Work is predominately done while standing or sitting.

  • The ability to comprehend, document, calculate, visualize, and analyze are required.

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An Equal Opportunity Employer

All BCBSLA EMPLOYEES please apply through Workday Careers.

PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)

Additional Information

Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.

If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact recruiting@bcbsla.com for assistance.

In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.

Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.

Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.

JOB CATEGORY: Quality Management

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