Program Manager, Medicaid - Remote
Blue Cross and
Blue Shield of North Carolina
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Blue Cross NC is improving healthcare
for everyone. Doing that takes all of us, currently 4,500+ strong! Are you
ready for a job that matters and a mission that is bigger?
The Program Manager position will lead the oversight and administration of
the Healthy Opportunity Pilots (HOP) and NC Integrated Care for Kids (NCInCK) programs for Healthy Blue, Blue Cross NC's
Medicaid program for North Carolina. The Healthy Opportunities Pilots are the
nationís first comprehensive program to test evidence-based, non-medical
interventions designed to reduce costs and improve the health of Medicaid
beneficiaries. The pilots will provide up to $650 million in Medicaid funding
for pilot services related to housing, food, transportation and interpersonal
safety and toxic stress in three regions of the state. North Carolina
Integrated Care for Kids is a new model aimed at improving the way children
and families receive care and support services in Alamance, Durham,
Granville, Orange, and Vance counties.
candidates for this position will have a working knowledge of HOP and NCInCK priorities and goals
with the enterprise, Healthcare and the Blue Cross NC Foundation to
ensure alignment across all segments
- Direct and
coordinate activities concerned with implementation and carrying out
objectives of programs.
- Establish and
monitor performance metrics and goals for assigned programs, including
process measures, outcomes measures, financial measures and
methodologies for implementing programs. Document and present program
results through operational reports, outcomes studies, presentations and
Healthy Opportunity Pilot
As part of
the Healthy Opportunity Pilot, you will service as a primary contact for
three HOP Network Leads and provide oversight for Alliance partner's work.
This work oversight will include:
- Billing and
Invoicing: Invoicing process that is more unwieldy than a claims process
(everything from reconciling to processing to payment)
- Data Analytics:
Ensuring that a specific percentage of pilot participants align with
- Financial: Financial
You will also
manage the relationship with Unite US (NCCARE360) for invoicing and
NCInCK work will include oversight of Alliance partner's
execution of the following work:
Quality improvement and operational excellence reporting on families
served by NCInCK
Measure equity in care and outcomes, which require some specific
strategy work and the subsequent execution
Health: Determining collaboration opportunities to address behavioral
degree and 5 years of experience in program or project management in the
area of program specialization.
- In lieu of
degree, 7 years of experience as stated above.
- North Carolina
residents strongly preferred.