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The hiring range for this role is: &nbsp;$224,000.00 - $271,000.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.Job Description Summary: Responsible to BCBS Plan and other key stakeholders to provide clinical expertise and leadership for medical affairs strategy development and implementation. Serves as a thought and opinion leader to provide clinical leadership and support to internal and external strategic initiatives in support of BCBSA and BCBS Plans. Works collaboratively with other medical directors to provide consultative leaders to the development of evidence-based reference medical policy information. Designs and implements innovative solutions that enable BCBS Plans to be proactive and that also enable industry leadership.Responsibilities include but are not limited to:<ul><li>Medical Affairs Leadership-Responsible to BCBS Plan and other key stakeholders to provide clinical expertise and leadership for medical affairs strategy development and implementation. Serves as a thought and opinion leader to provide clinical leadership and support to internal and external strategic initiatives in support of BCBSA and BCBS Plans. Provides clinical guidance and support to initiatives that address public health issues. Implements deliverables in support of BCBSA Board strategies and OCA key initiatives</li><li>Reference Medical Consultation-Collaborates with other medical directors to provide consultative leader and direction to Medical Policy Service in the development of evidence-based reference medical policy information.</li><li>Communication Management-Publication: Manage and undertake process improvement for the internal communication on timelines, evidentiary review, and deliverables. BCBSA Board Strategies: deliver the identified content in support of the BCBSA Board Strategies, including precision medicine and medical policy management</li><li>Ensure strong Thought Leader (TL) relationships; develop and nurture relationships with Key Opinion Leaders (KOLs) and consultants in the clinical community in order to strengthen BCBSA’s leadership position; serve as a professional representative of OCA in the healthcare community. Share responsibility with Clinical Operations for decisions regarding the recruitment and retention of pharmaceutical, medical device, as well as new business opportunities and strategies for product/platform development.</li></ul>Required Education, Certifications and Experience:Education<ul><li>M.D. or D.O.</li></ul> Certifications<ul><li>Medical license</li><li>Board certification</li></ul> Experience<ul><li>A minimum of 5 years health plan experience, as Medical Director or Medical Consultant with responsibility</li><li>Experience in representing Medical Affairs and Clinical Operations to consumers, businesses, providers and media</li></ul> Skills<ul><li>Demonstrated knowledge and experience of interaction of clinical operations with other Plan functions including but not limited to medical management, medical policy, legal, marketing, media, government relations, provider contracting etc.</li><li>Knowledge of medical policy implementation, claims operations and provider and account relations</li><li>Works effectively in cross functional teams</li><li>Works effectively with Plan Medical Directors</li><li>M.P.H. or other advanced degree is desired</li><li>Written communication and presentation skills</li></ul> People Management<ul><li>No</li></ul>#LI_HYBRID

Blue Cross Blue Shield Association

Medical Director, Medical Affairs

The hiring range for this role is: &nbsp;$290,000.00 - $330,000.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.Job Description Summary: The Vice President, Finance provides strategic leadership for BCBSA’s financial strategy, management, accounting, and technology services. Responsibilities include reporting to the Board and Finance and Audit Committee, overseeing Licensee Financial and Enrollment performance monitoring, and delivering high-quality services to Plan CFOs and senior financial constituencies. The position also focuses on building an adaptable, consultative, customer-focused team and maintaining expertise in industry best practices and technologies while fostering effective relationships with internal and external partners.Responsibilities include but are not limited to:<ul><li>Provide effective leadership to the Finance team, oversee the Management Team in managing the day-to-day operations. Coach, motivate, and implement appropriate training and career development opportunities for team members. This includes the communication and ongoing facilitation of performance feedback and appraisal processes. Serves as an active member of the BCBSA Senior Leadership Team</li><li>Provide leadership and strategic direction for the financial accounting function including payables, receivables, payroll, and tax preparation. Ensure there is an effective system of internal controls, including the development of financial policies and procedures. Work with internal and independent auditors to ensure reliable financial reporting, comply with applicable laws &amp; regulations, and safeguard Association assets.</li><li>Drive successful financial performance leveraging effective leadership of Financial Planning and Analysis, Decision Support, Forecasting, Budgeting, Resource Management and Management Financial Reporting. Builds and maintains consultative relationships with stakeholders across BCBSA, providing data and insights to support business decisions.</li><li>Oversee establishment and maintenance of system-wide policies on financial and enrollment reporting practices. Ensure credible Licensee financial and enrollment data is reported to BCBSA to support effective programs for licensure, compliance, and performance monitoring.</li><li>Manage the Insurance program for the Association and related Affiliate entities working with internal and external legal staff to evaluate risks, recommend insurance coverage where needed, and acquire coverage.</li><li>Develop and deliver high quality, timely, value-added services to Plan CFOs and other Plan executives.</li></ul>Required Education, Certifications and Experience:Education<ul><li>A Bachelor’s degree in Accounting or Business with an Accounting concentration which demonstrates knowledge of GAAP (Generally Accepted Accounting Principles) and Federal &amp; State regulations with CPA or MBA required</li><li>Master's Degree (Preferred)</li></ul> Certifications<ul><li>CPA (Preferred)</li></ul> Experience<ul><li>Ten (10) years of experience in a broad business background as well as a degree in Accounting or Business demonstrating extensive knowledge of GAAP, Government and non-government legal, regulatory and practice conventions required including FAR and CAS.</li><li>Eight (8) years of experience developing and managing staff</li></ul> Skills<ul><li>Knowledge of FEP, IRS and State regulations is required.</li><li>Demonstrated ability to manage, develop, motivate and provide leadership to management and staff.</li><li>Strong interpersonal skills required to lead in an employee empowered environment.</li><li>Demonstrated ability to manage multiple tasks in a fast-paced environment and the ability to effectively communicate results to senior management, other officers, Plan executives and board members of the Association.</li><li>Proficiency in various database and computer-based applications such as Workday, Power BI, Tableau, PeopleSoft, Excel, Word, and PowerPoint.</li><li>The ability to verify completed product, a detailed orientation is critical.</li><li>Effective written and verbal communication skills</li><li>Excellent organizational skills and demonstrated ability to manage multiple critical and time-sensitive activities in a fast-paced environment while maintaining poise and composure</li><li>Strong project management skills</li><li>Excellent customer service and a strong customer orientation and the ability to maintain and improve customer relations</li><li>Proven leadership abilities to guide staff in the development of new initiatives and system efficiencies; strong leadership skills to plan, manage, and direct operational functions with ability to implement change</li><li>Strong presentation skills and the ability to communicate concepts, issues, and proposals in a concise and compelling manner to small and large audiences at all levels in the organization as well as external parties; ability to conduct value-added and informative presentations to all levels of staff.</li></ul>Relationship management skills:<ul><li>Ability in the development and maintenance of business relationships</li><li>Ability in dispensing exceptional customer service and a strong customer orientation and the ability to maintain and improve customer relations</li><li>Strong quantitative, analytical, problem resolution skills, with financial concepts are preferred.</li></ul>People Management<ul><li>Yes</li></ul>#LI_HYBRID

VP, Finance

The hiring range for this role is: &nbsp;125,870.00 - 176,525.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.The Product Director will have business ownership overseeing the full lifecycle development for one or more of the inter plan product capabilities. They will lead a cross functional direct/matrix team through strategy, vision and execution applying product management paradigms. They will gain BCBSA and Plan consensus and governance approval of proposed strategies to address market needs. Accountable for building cross-functional relationships and strategic partnerships to fully assess impact of solutions, gain adoption of solutions and to develop communication strategies. This includes building bridges internally and within Plans between business and technology staff through effective strategic planning and prioritization. Accountable for building and maintaining strong working relationships with vendor partners including Blue Health Intelligence (BHI) and Consortium Health Plans (CHP). Represent BCBSA interests in national and government/regulatory forums. Frequent Plan interaction to present business case for initiatives and gain consensus.Leads and directs the transformation of one or more Enterprise Data Solutions assets, transaction processing capabilities and information assets, enabling the Blues to distinguish themselves in the marketplace. As Business owner, be responsible for system solutions and development of inter-plan capabilities including but not limited to member/claims capabilities, informatics applications, consumer engagement applications, and data services. Leads and directs cross-functional efforts and develops business justification for solutions that meets goals and objectives. Proactively implements and explores new solutions in support of emerging business needs and enhanced efficiencies. Responsible for directing the assessment of alternate solutions including the analysis of Plan specific and System-wide impacts associated with solutions. Accountable for improving the functionality, efficiency, and quality of support to Plans for business application solutions and for interactions with EIT division. Leads long-term planning and strategy development for one or more products including identifying business value, resource requirements and budget/timelines to ensure successful implementation internally and with Blue Cross Blue Shield Plans. Leads and directs the development of business requirements in response to strategic priorities. Accountable for building bridges between business staff and technology staff through leadership of cross-functional relationships, strategic planning and prioritization of enhancements and new requirements. Responsible for ensuring all inter-dependencies are appropriately identified and accounted for. Responsible for the financial management of business application projects, initiatives and ongoing support and maintenance budgets, including the development and execution of long-term business plans for one or more National Programs applications. Accountable for gaining BCBSA, Plan consensus and governance approval of proposed inter-Plan business applications and technology solutionsEducation Bachelor’s and Masters Degree in business, information technology, data analytics, healthcare or the equivalent work experience. Experience 7 years’ of experience with the development and implementation of major initiatives including cloud based applications. 5 years’ experience managing staff and budget. 10 years’ experience in progressive health insurance, in combination of both product/business development and operations. 10 years’ experience in software development methodologies and product management. Experience leading large data warehouse and analytical applications. Experience leading organization-wide initiatives and building consensus for business results in a decentralized decision-making structure. Demonstrated ability to lead in a matrixed environment. Experience with Agile development methodologies. Project management experience; demonstrated ability to set priorities, lead a team to meet objectives for complex projects involving multiple stakeholders, and execute according to plans and budget. Experience in the development of product roadmaps and strategies preferred. Analytic experience relating health care data preferred. Skills Relationship management skills.: Ability to work across all levels of the organization, including working with BCBSA staff, Plan executive and management audiences and vendors., Strong customer-service mindset.; Ability to develop key business partnerships both internal and external, build peer relationships. Strong consensus-building skills in a decentralized decision-making structure. Data analytical skills; ability to analyze data and processes, options, and alternatives to provide recommendations; analyze alternatives to derive final recommendations. Communication skills (oral and written): Demonstrated ability to effectively communicate recommendations, solutions, and project status to customers, senior management. Ability to communicate across multiple business and technology teams. Problem resolution skills: Ability to gain various viewpoints and arrive at critical decisions. The ability to problem solve independently and as part of a team. Demonstrated strategic thinking and approach to problem solving. Effective organization, presentation, and negotiation skills Ability to demonstrate good judgment and critical thinking skills relative to problem analysis/resolution at both the strategic and functional levels. Demonstrated ability to influence outcomes preferred. Extensive knowledge of Health Care industry and Health insurance systems and processes preferred. People Management YesInternals onlyPlease note that if you are an internal living in a non-commutable state, you are welcome to apply. However, you will be required to visit either the DC or Chicago office onsite work 20% of the time each month.#LI-Hybrid

Product Director

The hiring range for this role is: &nbsp;$180,000.00 - $215,000.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.Job Description Summary The Managing Director, Security Operations, Incident Response &amp; Threat Hunting will manage the team responsible for various security services in domains of Security Operations, Incident Response, and Threat Hunting. This role will lead a team of security engineers, analysts, and administrators responsible for maintaining security infrastructure, responding to security alerts, investigating/triaging security incidents, performing forensics detailed forensics analysis, building detection and monitoring rules, and building custom incident response tooling.Responsibilities include but are not limited to: ​<ul><li>Manage all SoC operations, technology administration, threat hunting programs, Incident response processes.</li><li>Establish processes to measure and report on team performance and business value.</li><li>Work with various business stakeholders to demonstrate the business value and operational outputs of the team at an executive level.</li><li>Ensure that forensic evidence is preserved and can be used for legal proceedings if necessary.</li><li>Research and monitor emerging security technologies, understand current industry and technology trends and opportunities, and assess their impact to the business.</li><li>Conduct research to identify new attack vectors facing BCBSA computing environment.</li><li>Work with and influence business contacts in regards to technology controls, risk mitigation techniques related to application layer security.</li><li>Develop and maintain applicable incident management program metrics for continual measurement and improvement.</li><li>Manage and motivate teams with diverse skills and backgrounds.</li><li>Assess and prioritize security risks and formulate effective risk management mitigation plans.</li><li>Collaborate with cross-functional teams to integrate security measures into business processes and applications.</li><li>Regularly review and update security documentation to reflect changes in the threat landscape and business requirements.</li><li>Participate in security audits, assessments, and certification processes.</li><li>Work closely with legal and compliance teams to address any security-related legal and regulatory requirements.</li><li>Lead incident response efforts, including investigation, containment, and resolution.</li><li>Lead post-incident analysis and implement corrective actions to prevent future occurrences.</li><li>Participate in the selection, implementation, and maintenance of security technologies.</li><li>Communicate effectively with stakeholders, addressing security concerns and providing guidance on best practices.</li><li>Assist in security-related documentation (RFPs, PPTs, etc.)</li></ul>Required Education, Certifications and Experience<ul><li>Bachelors Degree Computer Science, Information Technology, or related field required.</li><li>Minimum of 10 years information security experience with a heavy technical focus and with 7 years of progressively increasing responsibility.</li><li>Minimum of 5 years in a leadership position as a hiring manager or team lead capacity with experience developing and leading staff.</li><li>Experience/knowledgeable in conducting audits of information systems and their application to ensure accuracy of information and promote operational efficiency</li><li>Experience acting in a security incident response role with responsibility of analyzing alerts/threats, responding accordingly, developing incident response plans and procedures</li><li>Experience documenting incident cases and managing lessons learned meetings</li><li>Experience in working with Managed Security Service Providers (MSSPs) and ensuring alignment to agreed upon SLAs.</li><li>Experience in implementing and managing core TVM systems and processes such as: Security Event Management, Vulnerability Management, Web application firewall, data base monitoring, forensics toolsets, firewalls, proxies, packet captures, etc.</li><li>Experience in managing Information Security operational and capital budgets.</li><li>Experience with implementation of technical security architectures within a large enterprise environment is preferred.</li><li>Competency in making operational decisions, monitoring progress and reporting results.</li><li>Ability to communicate at all levels, with experience in leading operational review meetings with business partners and executives that may range from technical resources to VP/SVP.</li><li>Technical domain knowledge along with understandings for the costs for delivering the required services</li><li>Competency to Interpret and summarize technical information for presentation to non-technical business contacts</li><li>Knowledgeable in security technologies, procedures, and best practices to include functions such as Web Application Firewalls, Intrusion Detection Systems, Endpoint Detection and Forensics, SIEM, and Vulnerability Scanning</li></ul>Preferred Education, Certifications and Experience<ul><li>CISSP, CRISC, CISA or other relevant certifications preferred</li><li>Knowledge of the BCBS system and practices.</li></ul>People Management Yes #LI-Hybrid

Managing Director,  Secuity Operations

The hiring range for this role is: &nbsp;78,638.00 - 110,285.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.The "Consultant Employer Group Waiver Plan (EGWP) Operations position supports the vendor relationship, daily operations, and delivery of member benefits for Medicare Part D Employer Group Waiver Plan (EGWP). This position collects, maintains, and resolves issues, shares program operational and performance data, supports timely resolution of inquiries, communication development, process documentation, reporting, implementation, compliance, and audit activities in support of and in compliance with the Federal Employee Program (FEP) Program, CS 1039, Office of Personnel Management (OPM), and Centers for Medicaid Services (CMS) EGWP Part D policies and regulations.Primary Job Functions<ul><li>Oversees accurate and timely resolution of member inquiries including but not limited to CMS, OPM, internal and external sources.</li><li>Identifies performance and compliance risks and communicate to leadership timely to minimize non-compliance. Reviews and tracks weekly, monthly, and quarterly reporting to identify any issues and implement corrective action strategies as needed.</li><li>Assists with managing, tracking and approvals for communication requests, system updates, benefit changes in compliance with CMS and FEP requirements/standards.</li><li>Support and interact with internal and external stakeholders to provide timely resolution to inquiries and issues.</li><li>Fosters collaborative relationships with internal and external stakeholders and vendor account teams.</li></ul>Increase Program value:<ul><li>Implements new programs to increase the value of our services. This includes planning, implementation, data analysis, communications, and outcome management.</li><li>Review trends and industry information to determine best practices, operational efficiencies, or process improvements to enhance program performance and the member experience.</li></ul>Compliance:<ul><li>Support development of operational standard operating procedures (SOP), policy, brochures, training materials and curriculum.</li><li>Assist and support contract proposals, negotiations, counter proposals, SLA development, contract modifications and amendments.</li><li>Coordinates the development and maintenance of program reporting and continuous review for outcomes in alignment with FEP goals.</li><li>Support audit and compliance activities.</li></ul> EducationRequired: Bachelor’s degree in Pharmacy, Business, Accounting, Management, Health Services, Information Systems or equivalent work experience. Experience Required: Minimum of three years of experience within a business environment services delivery setting, with experience in project management, and/or healthcare informatics Preferred: • Experience in project management and/or account management• Experience setting priorities and meeting objectives for projects with multiple stakeholders• Technical proficiency with Microsoft Office, Teams and SharePoint Knowledge, Skills, and Abilities<ul><li>Project management skills for reporting multiple projects, involving multiple stakeholders, under tight deadlines</li><li>Advanced organizational skills with the ability to develop approaches that meet required objectives</li><li>Excellent communication (written and oral) and interpersonal skills with an ability to communicate to small and/or large audiences (both internal and external to BCBSA)</li><li>Technical proficiency with information technologies (e.g. Microsoft software applications)</li><li>Interpersonal skills with the ability to work with all levels of the Association, Plans, government and vendors</li><li>Ability to manage stakeholders and reconcile and integrate competing interests</li></ul>Revenue/Budget Responsibility: No People Management: NoTravel Requirements: 11-25%#LI-Hybrid

Pharmacy Technician Consultant  (Part-D)

The hiring range for this role is: &nbsp;125,870.00 - 176,525.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.Serves as clinical director of the Federal Employees Program pharmacy programs. Provides leadership and direction for the Federal Employees Program prescription drug benefit programs and Blue Cross Blue Shield Association initiatives to promote the cost-effective use of pharmaceuticals. Provides leadership in the development, management and evaluation of the Service Benefit Plan Formulary. Keeps abreast of and interprets trends within the pharmaceutical marketplace and healthcare industry which could affect pricing, delivery system, and benefit coverage and provider utilization and formulates strategies to respond to trends. Project responsibilities include project coordination, ability to set priorities, consensus building and providing reports to both peers and Executive level.Primary Job Functions<ul><li>Develops, manages, and evaluates drug formulary, drug utilization review programs, fraud and abuse programs, safety and quality monitoring programs. In addition, provides oversight over Pharmacy Benefit Manager clinical programs.</li><li>Interacts significantly with the Pharmacy and Medical Policy Committee as policies are being drafted for final review of the full Pharmacy and Medical Policy Committee. Has oversight of the contract and activities of support vendor for Pharmacy and Medical Policy Committee: creation of monographs, drug and class reviews. Presents recommendations for final vote of from Pharmacy Policy to Pharmacy and Medical Policy Committee members.</li><li>Formulates and coordinates integration of pharmacy clinical programs with overall Federal Employees Program administrative policy.</li><li>Provides leadership and support to pharmacy work groups, best practices, and forums.</li><li>Initiates new programs for managing utilization and increasing cost savings.</li></ul>Education Required: Doctor of Pharmacy degreeExperience:Required: A minimum of 5 years related work experience including 3 years in a leadership role.Certifications Required: Currently licensed as a pharmacist in the state of Maryland Knowledge, Skills, and Abilities<ul><li>Knowledgeable about how health care and patient care is delivered and how health care professionals interact in the health care environment, e.g., progressive experience in managing drug utilization review and formulary programs as well as Pharmacy and Therapeutics Committee experience.</li><li>Technical proficiency with information technologies (Microsoft software applications) is required.</li><li>Excellent interpersonal skills and presentation skills, including the ability to work with all levels of the Association, Plans, government agencies and vendors.</li><li>Leadership, organizational, analytical, and project management skills are also imperative, as well as the ability to solve problems, make sound business decisions, and communicate effectively, both in writing and orally.</li></ul>Revenue/Budget Management: NoPeople Management: NoTravel Requirements: 11-25%#LI-Hybrid

Director of Pharmacy Policy

The hiring range for this role is: &nbsp;$176,500.00 - $203,000.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holiday medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.The Director, Systemwide Cybersecurity and Compliance will manage key aspects of implementing our Systemwide Cyber Strategy and governance across 33 Plans and several Non Plan Entities that represent the Blue Cross Blue Shield System. The Director will also provide thought leadership and support to Management in their work with Systemwide CISOs and key internal stakeholders. The goal of this role is to collaborate with stakeholders to design, build, implement, and operate a strategy that meets the needs of the System as well as support the governance, risk and compliance process that is in place to ensure we are aligned, collaborative and providing value. The Director will also be responsible for ensuring that Systemwide strategy, as applicable, is communicated and implemented within the Association. This role offers a great opportunity to interact with CISOs and multi-disciplinary teams from across the Blue Cross Blue Shield System.Cybersecurity Strategy Development and ImplementationThe Director is responsible for creating and managing the processes by which Systemwide Strategy initiatives, examples include measuring cybersecurity maturity and the operational effectiveness of key security controls, are agreed to, defined, and achieved. The Director will lead those initiatives across the System to their intended outcomes on time and within budget and provide analytical and programmatic support as needed. The Director will also support the process of refreshing the cyber strategy every three years to ensure it is current, adding value and reducing systemwide risk.The Director shall be highly skilled at the following:<ul><li>Engaging with leadership in setting strategy and providing insights</li><li>Contributing to thought leadership in tackling a problem(s)%%Presenting findings to CISOs, Board subcommittees and cross functional teams</li><li>Ability to effectively distill and communicate ideas%%Project Management and reporting</li><li>Managing budget and associated contract engagements with vendors</li><li>Risk identification and classification</li><li>Delivering intended outcomes</li><li>Marketing, preparing and socializing communications</li><li>Providing training, education and awareness regarding information security requirements and expectations</li><li>Creating and managing metric programs as well as communicating related insights</li><li>Managing meetings and driving content to keep the focus on intended outcomes</li></ul> Program Governance, Risk and ComplianceThe Director will support governance of two workgroups, who meet quarterly, and are tasked with the following:<ul><li>Advising the Association and System on pertinent data security issues.</li><li>Fostering and supporting increased alignment among Blue System CISOs.</li><li>Increasing value through inter-Plan collaboration on security practices and cyber threat intelligence sharing.</li><li>Leverage expertise within the BCBS System on security issues.</li></ul> The Director shall be highly skilled at the following:<ul><li>Preparing and translating policies and standards and monitoring compliance</li><li>Preparing and socializing communications (quarterly newsletter etc.)</li><li>Creating and managing annual communication plans</li><li>Preparing and running surveys followed by distilling and presenting insights</li><li>Risk planning, mitigation, and remediation to address information security deficiencies</li><li>Creating and proofreading materials and findings to ensure clarity and resonance</li><li>Running complex meetings and preparing associated collateral (agenda, minutes, materials)</li><li>Collaborating with procurement, vendors and cross functional teams in planning and executing on program deliverables</li><li>Creating and managing calendars that detail key meetings throughout the year</li><li>Working effectively with others to meet a cyber program objective</li><li>Being an initiative-taker with minimum oversight needed</li><li>Being a collaborator who does not mind getting their hands dirty in some of the tactical aspects of meeting support (creating and distributing name tents, general meeting support etc.)</li></ul>Education<ul><li>Bachelors Degree; Computer science, information systems or related</li></ul> Certifications<ul><li>Certified information Systems Security Professional (CISSP) or like credential (required)</li><li>Certified information Systems Security Professional (CISSP) (preferred)</li><li>Certified Information Privacy Professional (CIPP) (preferred)</li><li>Certified Information Security Manager (CISM) (preferred)</li><li>Certified Information Security Auditor (CISA) (preferred)</li></ul> Experience<ul><li>A minimum of eight (8) years of experience in information security and program oversight</li></ul> Skills Critical competencies for success:<ul><li>Leadership skills: Must have the proven ability to lead the development, planning, coordination, and monitoring of information security risk management-related process, technology, and operations, and be a key part of the team’s leadership for governance aspects of information security. Must be able to communicate effectively regarding security, privacy, risk, and compliance to senior business leaders and fellow team members. As trusted counsel to senior management, the role requires a highly resourceful individual with emotional intelligence, self-motivation, and strong analytical and communication skills who is also willing to roll up their sleeves to support where needed.</li></ul><ul><li>Security knowledge: Able to draw upon proven experience to recommend and gain buy-in to numerous information security initiatives. Ability to lead a team by demonstrating subject matter expertise. This individual is able to represent the interests of the organization, gain support from stakeholders and formalize acceptance through the creation and adoption of policies, standards, and guidance.</li></ul><ul><li>Ability to deliver: This individual will have the proven ability to lead complex projects across various business and functional departments as they pertain to risk and security matters. Ability to create a project management mindset with clear objectives, goals, processes, and measurable outcomes.</li></ul><ul><li>Risk-based methodology: Must demonstrate acute application of risk-based decision-making. This person should enable business decisions and strategy yet strike a balance between the desires of the business and the risk-profile required to protect information assets.</li></ul> People Management No#LI_HYBRID

Director, Systemwide Security

The Cloud Computing Engineer owns the designs, development, configuration and delivery of cloud infrastructure environments a variety of applications across BCBSA using best practices and business acumen. This role includes managing the technological aspects associated with one or more of the following: cloud computing technology stack, including architecture, security, design, planning, management, maintenance, support, storage and backup. The scope of the role includes the extensive knowledge of on premise (private), off-premise (public) and hybrid cloud models along with cloud implementation service models (IaaS, PaaS and SaaS). May manage the technologies and techniques to automate the provisioning and management of software defined infrastructure in a distributed cloud environment through scripting and coding. Lead/oversee the cloud infrastructure environment construction and implementation during the life cycle of the solutions. Evaluate the success of architecture, network, security and environment designs as they are implemented. Evaluate strengths and flaws in architecture, network, security and environment designs for continuous improvement. Communicate with management and technical personnel on cloud adoption and usage topics on a continuous basis. May be required to represent EIT in a project as a technical lead. May be required to coordinate with other EIT personnel.<ul><li>Efficiently translate project requirements from architecture/environment diagrams to formulate appropriate questions to identify and remediate design gaps. Review and analyze architecture level security solutions at the domain or product level to transform them into cloud infrastructure designs and implementations. Establish strategic relations with key technology vendors in order to influence changes in future product releases. Must have experience with cloud technologies including but not limited to compute, storage, network, and databases.</li><li>Drive the design of self-healing and fault-tolerant cloud services and infrastructure environments with best practice configurations for a wide variety of systems including databases, web services and messaging systems, and other application support environments. Efficiently translate project requirements from architecture/environment diagrams to formulate appropriate questions to identify and remediate design gaps. Review and analyze architecture level security solutions at the domain or product level to transform them into cloud infrastructure designs and implementations. Establish strategic relations with key technology vendors in order to influence changes in future product releases. Must have experience with cloud technologies including but not limited to compute, storage, network, and databases.</li><li>Accountable for conducting research and benchmarks best practices and/or products in the area of cloud technologies. Routinely gathers and assesses changing BCBSA business needs. Analyzes and modifies enterprise technology strategy and architecture. Analyzes how business processes interact with technology to create value for the business. Maintains knowledge of cloud technologies, trends, and standards. Provides input to the content of Requests for Information / Proposal (RFI/P) around the BCBSA technology architecture / infrastructure requirements and guiding principles. Conducts trend analyses to track emerging industry trends and technologies. Research, and assist in the piloting the evaluation of new tools, technologies, and/or processes to maintain and enhance the critical system infrastructure.</li><li>Manages cloud configuration to ensure systems are up-to-date to latest security patches and operational resilience to incidence. Work with EIT staff to plan and ensure updates are conducted on a timely basis across all Enterprise systems. Develop technical solutions and new security tools to help mitigate security vulnerabilities and automate repeatable tasks. Possesses a thorough understanding of cloud security fundamentals, such as; Encryption, Key Management, Identity to/from the cloud, shared cloud security, logging and monitoring cloud infrastructure. Automate the process of patching and vulnerability remediation. Continually evaluate new cloud infrastructure threats with associated mitigating designs and their impact on IT and Business operations always balancing these needs to develop and implement the best security solutions for the business.</li><li>Owns development of cloud computing templates and implementation guidance for applications that leverage IaaS solutions to meet BCBSA use cases. Integrate application design strategies to include the design of loosely coupled cloud resources to allow for a redundant and resilient end user application design. Assist in performance improvements while ensuring security controls are in place protecting the network and data. Work with EIT staff including Enterprise Architect, Delivery teams, core computing and application support team to ensure adequate system performance based on business requirements and industry best practices.</li><li>Documentation of new cloud computing Application design guidelines for both new business applications and the porting of existing BCBSA Business applications to align with a cloud model. Participate and conduct liaison activities in reviewing the application designs, providing recommended alterations to designs, and partnering with enterprise architects to transform current application design principles to be more cloud aligned. Coordinate and/or complete the development of all necessary design documentation associated with cloud service solutions. These are to include all aspects of cloud solutions such as application resiliency, disaster recovery, build book creation, and run book creation</li><li>Independently use judgment and takes action on it to build credibility with clients and technical staff through the delivery of sound cloud based business solutions. Consults with business and Enterprise IT Leadership and project staff to fit systems to solutions and identify when it is necessary to modify technical infrastructure to accommodate project needs.</li><li>Leads projects in close collaboration with network and application security engineers to assure BCBSA applications and systems are designed and configured to conform to general and product/application specific security architectures and to the security polices, guidelines and best practices provided by the Business Protection group for the protection of sensitive healthcare data. Owns service design and pricing in the context of cloud-based suctioning</li><li>May drive the design of self-healing and fault-tolerant cloud services and infrastructure environments with best practice configurations for a wide variety of systems including databases, web services and messaging systems, and other application support environments.</li><li>May lead the ongoing administration, maintenance, and problem resolution of existing SAN/NAS storage infrastructure and related software. Design, implement, and maintain SAN and NAS storage appliances/solutions for use by Cloud and other compute infrastructure. Configure data protection using Snapshots and SnapMirror, and manage Aggregates, Volumes, and LUNs on NetApp filers. Execute data migration to cloud environments using ONTAP, defining migration objectives and utilizing appropriate tools.</li></ul>Education<ul><li>Required: High School</li><li>Preferred: Bachelors Degree; Bachelor's Degree in Computer Science, Information Security, related discipline or equivalent experience in the field.</li><li>Preferred: Masters Degree</li></ul> Certifications<ul><li>Certification in one Cloud Platform (AWS or AZURE preferred)</li></ul> Experience<ul><li>8+ years or more of enterprise-level Infrastructure consulting or implementation experience.</li><li>5+ years experience in a network focused hands-on technical role working with routing protocols/technologies and platforms in large scale data center and/or WAN network environments.</li><li>5+ years experience in a technical on-call capacity, responding to customer impacting events, mitigating and root cause analysis of those events.</li><li>5+ years experience developing engineering, deployment, or operations mechanisms to support IP network and/or networking systems.- Thorough understanding of TCP/IP networking, IP routing, Server Load Balancing, and Network Security architecture and core technologies such as IP, TCP, OSPF/IS-IS, BGP, MPLS, Server Load Balancers, Firewalls, ACLs, DNS, DHCP, IPAM, LDAP, NFS, etc.</li><li>Experience leading network projects in the areas of network sustaining engineering, network deployment/implementation, network scaling, technology refresh, best practices application, and/or network optimization.</li><li>Experience leading the engineering and evolution of highly available networks in cloud (especially AWS) and on-prem data centers.</li><li>Experience working with dev ops teams to automate network deployment and operations.</li><li>Experience troubleshooting network routing, interconnectivity, platforms, performance, and configurations issues; including necessary low level application interaction, Unix systems, and new age networking software tools.</li></ul>Skills<ul><li>Experience with Chef, Puppet, Ansible, Powershell or other automation environments and scripting technologies.</li><li>Experience moving workloads from on premise to IaaS (Openstack, AWS, Rackspace, Azure, Druva etc.)</li><li>Networking experience, including VPN configuration is a requirement.</li><li>Familiar with Containerization</li><li>Experience with network technologies and with system, security, and network monitoring tools</li><li>Advanced working knowledge of the technical aspects of:</li><li>Application protocols, such as HTTP(S), SMTP, SSL, and DNS</li><li>Common applications of cryptography, such as X.509 PKI, PGP, etc.</li><li>Knowledge of Active Directory</li><li>Security event and log management</li><li>Identity and access management</li><li>Encryption in the cloud</li><li>Thorough understanding of the latest security principles, techniques, and protocols</li></ul> People Management No#LI_HYBRID

Cloud Computing Engineer II

The hiring range for this role is: &nbsp;$107,666.00 - $150,995.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holiday medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.Develops (authors) evidence-based medical policy reviews to provide timely, clinical effectiveness information on medical technologies (i.e., procedures, devices, diagnostic tests, and drugs). Analyzes medical evidence and drafts medical policy, including complex analyses and evidence synthesis, for review by the BCBSA Medical Policy Panel (MPP-a panel comprised of Plan clinicians/medical directors) and in select cases review by the BCBSA Medical Advisory Panel (MAP-an external panel comprised of nationally recognized experts in technology assessment, clinical research and clinical practice).Identify, critically appraise, and summarize scientific literature and clinical practice guidelines for medical technologies (procedures, devices, diagnostic tests and drugs). Perform thorough and objective analysis of the research design and validity of conclusions of current literature and unpublished data. Prepare clear, documented and defensible reports that summarize this information as evidence summary reports for presentation to the MPP and MAP. Provide technical expertise to facilitate the Panel’s review processes. Contribute to the scientific quality, credibility and consistency of BCBSA Reference Medical Policies through participating in the peer review process and various learning activities (e.g., Learning Sessions, Journal Clubs, Medical Advisory Panel meetings, team meetings). Utilize expertise in designated clinical specialty to serve as resource to Medical Policy Services (MPS) staff and the MPP. Additional MPS project work contribution: Support MPS Leadership in managing/performing various MPP-related operations and other special projects as requested (e.g., Contribute to research needed for updating search strings, research on topics salient to the BCBSA external engagements and quality measure when requested, etc.)Education<ul><li>Required - Masters Degree; MPH, MHA, MS or equivalent in biomedical or biostatistical science or evaluation research.</li><li>Preferred - PhD; PhD. PharmD.</li></ul> Experience<ul><li>Research and/or clinical experience in researching, analyzing and presenting synthesis of clinical data</li></ul> Skills<ul><li>MPH, MHA, MS or equivalent in biomedical or biostatistical science or evaluation research.</li><li>Research and/or clinical experience in researching, analyzing and presenting synthesis of clinical data</li><li>Demonstrated methodological skills in evaluation of research design, statistics or critical appraisal of clinical studies.</li><li>Ability to work independently to generate, synthesize and analyze data, reports and tables.</li><li>Technical proficiency with information technologies (e.g. Microsoft Office) and literature-searching.</li><li>Excellent verbal and written communication skills, problem solving and organizational abilities.</li><li>Demonstrated ability to manage multiple projects with overlapping timetables.</li><li>Demonstrated presentation skills to facilitate the review and understanding of materials.</li><li>Experience in working collaboratively with physicians, clinical investigators and research scientists.</li><li>Ability to work effectively as a team member.</li></ul> People Management No#LI_HYBRID

Sr Research Scientist

The hiring range for this role is: &nbsp;-This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holiday medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.Job Description Summary Function as the technical resource across several BCBSA technical projects focusing on the software products developed and supported by Information Technology to ensure these applications meet stakeholder needs. Provides services for Plans and BCBSA staff, including providing 2-4 tier product support in conjunction with Information Technology’s engineering and development teams. Support and interact throughout BCBSA with team members and outside the team with application users, as well as with cross-functional teams.Responsibilities include but are not limited to:Responsible for the maintenance and administration of application and server resources. In addition, provide analysis, evaluation and support of the environment operation, which includes monitoring systems, resources, applications and users to ensure maximum system availability. Provide both order-of-magnitude and detailed estimates for software development activities and artifacts. Develop and refine estimating models based on previous project actuals and trends to improve accuracy of estimates. Perform troubleshooting and debugging of Information Technology systems and products to improve performance of products. Partner with business partners and develop teams to identify and implement process to provide technical operations and testing of applications. Follow good documentation practices, including producing and managing formal artifacts as well as writing clean, readable and standards-compliant code and unit tests. Serve as serve as primary or backup contact to define non-functional specifications and contribute/ drive to application/system design for supportability, maintainability and reliability aspects. Follow good documentation practices, including producing and managing formal artifacts as well as writing clean, readable and standards-compliant code and unit tests. Serve as serve as primary or backup contact to define non-functional specifications and contribute/ drive to application/system design for supportability, maintainability and reliability aspects. Supervise project teams in a matrix environment. Monitor milestone and project status. Partner with internal and external consultants.Required Education, Certifications and Experience<ul><li>Bachelor’s Degree in Computer Science, Information Systems or equivalent work experience in similar work environment.</li><li>Minimum 7+ years of IT work experience focused in production support.</li><li>Experience as a team lead or member on project teams in a cross functional environment.</li><li>Experience within a customer focused environment</li><li>Expert knowledge of design, implementation, and management and support of some or all of the following: Oracle, DB2, UDB, MySQL, MS SQL. Vertica.</li><li>Strong analytical skills.</li><li>Strong team-oriented interpersonal and communication skills to lead team efforts.</li><li>Thorough understanding of technical concepts required for specialized field. Uses that knowledge, creativity and company practices and priorities to obtain solutions to complex problems.</li><li>Excellent written, verbal and listening communications skills.</li><li>Ability to communicate effectively with Plan management at all levels of the organization.</li></ul>Preferred Education, Certifications and Experience<ul><li>Expertise in AWS data technologies such as Amazon RDS, Data lake, DynamoDB, Snowflake.</li></ul> People Management No #LI-HybridThis is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp;&nbsp;&nbsp;$107,667.00 -150,995.00We may ultimately pay more or less than the hiring range and this hiring range may also be modified in the future.&nbsp;&nbsp;A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonus incentive pay.&nbsp;We offer a comprehensive package of benefits including paid time off, 11 holiday medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.&nbsp;Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.&nbsp;Compensation Grade:14Please note that you must be in your current position for a minimum of 6 months to be eligible to apply for other internal positions.

22 Blue Cross Blue Shield Association Jobs