ECP Genetics Program Manager job Rancho Cordova California
ECP Genetics Program Manager job Rancho Cordova California
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ECP Genetics Program Manager Job



Employer Name: SpiderID: 13010962
Location: Rancho Cordova, California Date Posted: 11/24/2022
Wage: Negotiable Category: Insurance
Job Code: 170029H-2191

Job Description:
Looking for a chance to do meaningful work that touches millions? Come join the hardest working, nonprofit health plan in California and help us shape the future of health care. Blue Shield of California's Mission is to ensure all Californians have access to high-quality care at an affordable price. Blue Shield is focused on improving health care delivery by working closely with providers and making it more accessible, affordable and customer-centric. Being a mission-driven organization means we do much more than serve our 4 million members: we were the first health plan in the nation to limit our annual net income to 2 percent of revenue and return the difference to our customers and the community, and since 2005 we have contributed more than $325 million to the Blue Shield of California Foundation to improve community health and end domestic violence. We also believe that a healthier California begins with our employees, so we provide them with resources to develop and maintain a healthy lifestyle through our award-winning wellness program, Wellvolution.


We're hiring smart thinkers and doers who want to work for a leader and innovator in the challenging, ever-changing healthcare space. Come and help us make health care better for everyone.



Description:




* There's never been a better time to join Blue Shield!

Looking for a chance to do meaningful work that touches millions? Come join the hardest working, nonprofit health plan in California and help us shape the future of health care. Blue Shield of California is focused on transforming health care by making it more accessible, affordable and customer-centric. Being a mission-driven organization means we do much more than serve our 3.5 million members: we were the first health plan in the nation to limit our annual net income to 2 percent of revenue and return the difference to our customers and the community, and since 2005 we have contributed more than $325 million to the Blue Shield of California Foundation to improve community health and end domestic violence. We also believe that a healthier California begins with our employees, so we provide them with resources to develop and maintain a healthy lifestyle through our award-winning wellness program, Wellvolution.
We're hiring smart thinkers and doers who want to work for a leader and innovator in the challenging, ever-changing healthcare space. Come and help us make health care better for everyone.




* Job Details
Business Unit: Health Care Quality & Affordability / Business Area
This position will be part of the Medical Policy and Clinical Code Integration Team in the Medical Care Solutions Organization.

Position Title and Summary :
ECP Genetics Program Manager. The position will be responsible for the management of the ECP genetic testing/molecular diagnostics program.


The ECP Genetics Program Manager reports directly to the Sr. Manager for Enhanced Clinical Programs (ECP). This position interfaces, supports and collaborates with the Sr. Medical Director for Policy and Technology Assessment, Health Care Quality and Affordability Operations Directors and Managers and Data Analytics. The ECP Genetics Program manager will work closely with the Sr. Manager of ECP to identify and implement creative solutions and programs to support ongoing cost of healthcare savings and quality of care improvements in the delivery of molecular diagnostics as well as the overall efficacy, safety and quality of healthcare. The ECP Genetics Program Manager will also be responsible for researching and analyzing genetic test clinical utility, analytic and clinical validity data, managing network relationships, supporting medical policy development and keeping abreast of industry program trends. The ECP Genetics Program Manager will also support the successful implementation and ongoing tracking of program effectiveness and efficiency. The ECP Genetics Program Manager is specifically responsible for:


• Support research and development of business cases for ECP and CED genetic programs.

• Manage and support molecular diagnostic laboratory business partnerships.

• Support genetics medical policy review and development.


• Manage and support the ECP genetics registry.


• Defining business requirements and providing analysis to increase operational efficiency.


• Manage and analyze genetic testing claims and data reporting utilization trends and unit cost. Reporting this data against plan and forecast and recommending interventions where appropriate.


• Identifying opportunities for improvement in operational performance and notifying management of issues and problems requiring immediate attention.


• Works cross-functionally in analyzing, designing, and developing business solutions.


• Provides overall genetics support for BSC medical directors and nurses, as well as appropriate BCBS Association representatives.


• Coordinates and maintains membership within the BSC genetics task force.


• Research and develops business cases for genetics ECP and CED programs.


• Monitor, identify and execute on solutions for enhancement of genetic programs.


• Provide detailed medical research analysis for ECP and ECP program discoveries.


• Provide support and analysis for Special Investigations Unit, where appropriate.


• Assist in writing, maintaining and distributing of all internal and external communications related to medical policy.


• Collaborate with internal departments as needed in order to achieve departmental goals and complete all other duties as assigned.


• Serve as a project driver for approved projects.


Required knowledge, skills and experience for this role include the following:
    Strong clinical understanding of molecular, cellular and genetic medicine. Strong clinical understanding of genetic testing in medicine and healthcare. Strong payer knowledge with an understanding of utilization management, quality improvement, contracting and benefits, coding, payment and coverage. Strong independent judgment, critical and analytical thinking, problem-solving and data-driven decision making skills. Ability to partner, collaborate with and influence relevant stakeholders. Strong clinical research and healthcare economics skills. Demonstrated ability to drive to quality decisions with teams, peers and leaders. Highly skilled in interpersonal and verbal/written communications, presentations, predictive statistics, analytical and problem-solving, use of analytical tools (e.g., MiniTab, Excel graphs) organization skills and facilitation skills.
• Ability to identify, analyze, and resolve cross-functional problems related to business operations utilizing statistical analysis methodology.

• Advanced project management skills.
    Strong understanding of the business of health care.













Qualifications:




* Job Required Education/Experience

    Requires a Master's Degree in Molecular Biology or Genetic Counseling from a program accredited by the Accreditation Council for Genetic Counseling (ACGC) Proficiency in Microsoft Office products (i.e., Outlook, Word, Excel, PowerPoint)


Job Additional Education/Experience



    Previous medical policy review/development experience preferred Previous experience working in collaboration with or in direct employment of molecular diagnostic laboratory preferred Previous program management experience preferred Working knowledge of reimbursement coding, payment and coverage, preferred Prior Health Plan, ASO, or IPA/MG experience preferred












Job Criteria:
Start Date:
Position Type: Full-Time Permanent
Years of Experience Required:
Education Required:
Overnight Travel:
Vacation Time:


Contact Information:
Contact Name: Blue Shield of California Company Type:
Company: Blue Shield of California
City:
State:
Zip:

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