The Clinical Pharmacist Pharmacy Policy supports the Director Pharmacy Policy in all clinical functions including but not limited to Prior Approval policy creation and maintenance. Supports the direction for the Federal Employee Program's prescription drug benefit programs and Association initiatives to promote the cost effective use of pharmaceuticals. Provides support in

Identifies and proactively develops policy recommendations that further the BCBS mission and drive solutions to better support the over 115 million Americans BCBS Plans cover. Identifies and analyzes proposed regulatory and legislative initiatives at the federal and state level which present significant implications to BCBS Plans' members and clients. Identifies policy que

Job Description Summary The Dir Lab Precision Medicine within the GPO will lead mid and large projects/contracts to help develop strategic contracting opportunities to improve the economic and financial competitive positions of the Blue System. Provides senior management of business operations and project implementation of multiple national scale Lab/Precision medicine agr

The Senior Data Engineer will be a key resource at Synergie, supporting IT and Analytics in developing creative and innovative solutions to support business and analytic outcomes. In this exciting role on a small team, you will have a big impact by working closely with both IT and business to create new technical systems, data models and processes that support "Lowering Me

Job Description Summary Responsible for the design, development and implementation of advanced technology systems and data standards to meet the needs of business. Partners with customers to understand business requirements to create the technical functional specifications. Acts as an internal data consultant to advise and influence business and technical partners. This ro

Synergie Medication Collective is a new medication contracting organization founded by a group of Blue Cross and Blue Shield affiliated companies to serve both Blues and select independent health plans. Synergie is focused on improving affordability and access to costly medical benefit drugs ones that are injected or infused by a health care professional in a clinical sett

Executes measures for the prevention, identification and investigation of fraud, waste, and abuse (FWA) perpetrated against the Federal Employee Program (FEP). Ensures that Blue Cross Blue Shield (BCBS) Plans and Pharmacy Benefit Managers (PBMs) meet reporting requirements as mandated by the Carrier Letter and FEP Special Investigations Unit (FEP SIU) Standards Manual. Pro

The Executive Director supports strategic and operational leadership of the BCBSA Clinical Team, including support of the creation of the clinical operations strategy and delivery of value added resources and tools. This role provides clinical expertise and population health thought leadership in support of delivering more affordable and quality care for all members. In ad

Provides oversight and management of all drug utilization and spend across both the Pharmacy and Medical drug benefit. Provides operational oversight and management of the FEP Employer Group Waiver Plan program and Medicare Part D business. Works with contracted PBM's, executives, and operational staff on ongoing contract administration and maintenance. Leads the dire

Job Description Summary 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

The Senior Consultant Internal Audit plans and leads audits of BCBSA operational, financial, governance, risk management and compliance processes. Audits are performed across all business units to identify risks and evaluate internal controls according to BCBSA and professional standards. Specific areas of focus include control design, operation and efficiency, policy comp

Provides strategic leadership for all current FEP member facing products (Medical, Dental and Vision, Postal and Overseas) as well as future portfolio expansion to meet enrollment goals and profitability targets. Works collaboratively with Actuarial team to develop the strategy for product pricing, and competitive scenarios to manage portfolio stability. Responsible for wo

Develops, implements and administers Federal Employee Program (FEP) financial policies to ensure FEP compliance with the requirements of the Federal Acquisition Regulation, the Federal Employee Health Benefit Acquisition Regulation, the applicable Cost Accounting Standards, the Financial Accounting Standards, and the terms of the FEP contract, C.S. 1039, as well as to ensu

Job Description Summary Are you passionate about cyber risk management? Are you someone who enjoys creating new and collaborative processes? Do you enjoy helping others succeed by leading in risk based decision making discussions? We have an opportunity for you at BCBSA Information Security. We are looking for a cyber risk management leader (Director level role) to lead th

Lead federal and regulatory national health information technology and interoperability strategy for BCBSA by developing federal policy positions and federal outreach activities to ensure BCBSA is able to effectively influence the development and implementation of a nationwide, interoperable health care system. Position will be highly visible within BCBSA and externally to