Business Lead for Health Information Exchange and Innovation

The hiring range for this role is: 

107,666.00 – 150,995.00

This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the hiring range and this hiring range 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. This job is also eligible for annual bonus incentive pay. 

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. 

Lead projects aimed at setting industry data standards for health information management and exchange initiatives that impact the payer community. Supports BCBSA’s clinical data exchange program priorities with health data interoperability accelerators, leveraging the industry standards to enhance clinical and structured health data sharing among Plans and BCBSA health IT stakeholders. Manages BCBSA health information management initiatives, striving for industry consensus on healthcare administration standards and leading the development of stances on operational issues that align with the interests of BCBSA, Business Solutions, Office of Policy Representation, Federal Employee Program, and the BCBS System. Collaborates with Market Solutions management to assess the impact of federal initiatives such as the Interoperability Rules on the BCBSA strategic goals.

Primary Job Functions

• Lead and recommend solutions for the implementation of health information exchange and industry initiatives. Collaborate with key internal and external stakeholders to discern the implications for BCBSA, BCBS Plans, and Market Solutions arising from regulatory and industry activities. Define business needs and shape the development of policies and operational recommendations to meet regulatory requirements.
• Guide and support discussions with Plan subject matter experts to help develop BCBSA’s stance and offerings related to health information management and exchange issues. Deliver presentations at BCBSA or Plan-sponsored meetings and conferences that concentrate on national health information management and exchange standards. Engage with relevant groups to ensure the integration of HIE and national standards information into their development priorities, maximizing the dissemination of the BCBSA message and maintaining the visibility of the Blues’ efforts.
• Assist other BCBSA divisions involved in healthcare data and information initiatives by offering insights on national standards activities and evaluating their impact on health plan operations. Collaborate with these sectors to maintain consistent positions across BCBSA on emerging HHS and CMS health data interoperability issues, leveraging external expertise to enhance operational efficiency and communication.
• Represent and advocate for National Programs at external committees, workgroups, and industry initiatives to ensure the representation of BCBSA interests.
• Provide support to Business and Interoperability Solutions leadership and staff in adopting industry standards for specific projects. Offer subject matter expertise as the Blues utilize health and clinical data for strategic initiatives steered by the Board’s implementation and data use committees, aiming to fulfill current and future BCBSA strategic goals.

Education, Experience, and Certification

Education

Required: Bachelors Degree in a related discipline or equivalent experience.

Preferred: Master’s degree in business, health administration or related field is desirable.

Experience

Required:

Minimum of eight years healthcare industry experience with demonstrated understanding of health information management systems and knowledge of health care delivery issues, policy development methodologies, laws and regulations. Minimum of five years experience managing projects and team/resource leadership skills.

Minimum 5 years of experience managing projects and team/resource leadership skills.

Certifications

RHIA, HL7 FHIR Proficiency, HL7 2 (V2), or a Project Mgmt Professional (PMP)

Knowledge, Skills, and Abilities

• Expertise in leveraging extensive knowledge and relationships to identify issues, analyze them, and devise appropriate strategies and responses, showcasing excellent judgment, analytical skills, and creativity
• Frequent interaction with peers, BCBSA staff (e.g., OPR, Enterprise Architects, business and technical staff), and external stakeholders such as HHS, CMS, other governmental agencies, and federal committees.
• Regular engagement with project team leaders and direct collaboration with supervisors in a leadership role.
• Excellent oral, listening, and written communication skills for individual and group interactions.
• Skilled in data analysis and the business application of information systems and technology.
• Capable of facilitating, leading, and/or managing discussions or processes in various settings to achieve resolution.
• Adept at building consensus on complex issues and balancing multiple competing demands, both internally and externally.
• Strong interpersonal abilities, including effective public speaking, are highly desired;
• Skilled in developing and maintaining relationships.
• Continuous involvement with national organizations like WEDI, HL7, HIMSS, AHIMA, provider organizations/associations, competing national payers, and HIT vendors.
• Proficient in Microsoft Office applications for document preparation, presentation graphics, spreadsheets, etc.

Financial Responsibilities

Revenue Management: No

Budget Management: No

People Management: No

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