CareFirst– FEP Benefit Administration Manager


Job Title: Manager, FEP Benefit Administration

Location: Portals/DC

Career Band:   C

Job ID #: 8798

SUMMARY: Responsible for developing business solutions for the national BlueCross BlueShield Federal Employee Program (FEP). The solutions will leverage a business architecture and design, process modeling, and rapid prototyping approach to defining FEP Benefits Administration product requirements along with other FEP product and services.  Responsible for business leadership in defining business requirements for FEP products that will support current and future needs of the FEP program. Incumbent must have experience in business design and requirements methodologies including business architecture, business process modeling, market/competitive analysis and use case development. Position requires the ability to manage a center of expertise in business analysis and requirements development. Participates in strategic planning exercises with senior management and must be able to develop multi-year roadmaps for the evolution of FEP products and services. The incumbent is responsible for annual resource and budget plans for up to 15 associates and contractors. Resource management responsibilities for multiple strategic projects and releases running concurrently. Resource management responsibilities require balancing the needs of maintenance and development priorities.

PRINCIPAL ACCOUNTABILITIES: Under the general supervision of a Senior Director the manager’s accountabilities include, but are not limited to, the following:

  1. Developing business solutions for national Federal Employee insurance program allowing BCBSA FEP Program and CareFirst to maintain a competitive edge in the marketplace. Leads the development of business solutions using business architecture, process modeling, joint application development (JAD) sessions and rapid prototyping to define business requirements.  Leads and mentors highly skilled business and requirements analyst professionals. Participates in strategic planning exercises with senior management and creates multi-year roadmaps for the evolution of FEP products and services. The incumbent is accountable for maintaining a business definition of all FEP applications which supports the strategic direction of the organization and near-term needs of our customers. The incumbent is accountable for setting the direction for benefits administration and industry code management, and ensuring all their associates are trained and consistently following the methodologies defined. Ensures the quality of software releases by ensuring standard requirements methodologies are followed and requirements traceability provided. Manages staffing requirements within the team to ensure that each is consistent and adequate to meet the division’s strategic objectives. Ensures statement of work (SOW) service level requirements are met or exceeded.
  2. Manages the baseline budget for their organization and justifies any variances from budget. Evaluates performance of each team member, generates development plans and sets goals within the context of the corporate policy.  Must also motivate, coach, counsel and develop team members within the context of the corporate policies and manages the team’s budget. Ensures that staff has appropriate tools and training.
  3. Has direct interaction and communication with customers and strategic partners to set strategy for future implementations.  Work closely with the customers to ensure the short and long term business needs are being addressed while proactively avoiding potential issues.  Manage resolution of production problems by providing workarounds to allow customer to continue business until production problems are resolved, establish service level requirements (SLRs), and provide consulting services related to FEP products and services. Monitors, tracks, and reports on incentive and non-incentive SLRs. Communicates with Directors, Vice Presidents and other Corporate management to plan and implement Division Strategic Objectives. The manager also communicates with other IT and client personnel as well as vendors, consultants, auditors, other Blue Cross and Blue Shield Plans, Blue Cross Blue Shield Association (BCBSA), the FEP Director’s Office (FEPDO), and the Office of Personnel Management (OPM) to coordinate and implement system projects and enhancements.
  4. Establishes strategic plans and roadmaps for FEP products and services and enforces continuous process improvement practices through the use of concepts such as product management, business process modeling and architecture, knowledge management, root-cause-analysis, and performance metrics. Stays current on recent developments is product/solution lifecycle, business design and architecture, and industry best practices to continue to evolve the organization’s business expertise in order to better support our customers’ current and future needs.

    Required: This position requires a bachelor’s degree in Computer Science, Information systems or related field or equivalent work experience. Must have 7+ years of technical experience in claims-benefit administration systems management or product development/management experience in the healthcare industry.  Must have relevant experience developing business solutions for mission critical projects using a business architecture and process modeling approach, joint application development (JAD) sessions and rapid prototyping to define new concepts to improve FEP products and services.  Experience leading and mentoring highly skilled analyst professionals.  Background in creating multi-year product roadmaps and presenting to senior management and customers for approval and funding.  Proven ability to budget, organize and manage large teams made up of associates and contractors. Must be able to set priorities and multi-task between many simultaneous strategic projects and day-to-day maintenance related activities.

    The key core methodologies and the associated tools are listed below.
    -Technical Product Management
    -Project Management
    -Business Architecture Definition
    -Business Requirements
    -Business Process Modeling
    -Business Rule Development
    -Joint Application Development (JAD)
    -Agile Development Methodology
    -HP -ALM

    Abilities/Skills: Strong product management, business requirements management, business architecture and process modeling concepts, and rapid prototyping skills. Prior experience with methodologies and tools related to the department’s core activities. Must have extensive experiences within specific areas such as product management, business/systems analysis, business architecture, process modeling and requirements definition. Must have excellent written and verbal communication, interpersonal and analytical, and problem-solving skills. Must have the ability to consult with external customers and manage customer relationships and expectations.  Experience with mission critical projects, preferably in all business analysis phases of the systems development life cycle.  Experience in collaborative team leadership. Must be able to coach, develop, and motivate associates.

    Preferred: Broad knowledge of BCBS business, system, and operational processes. Previous experience in the health insurance business. Experience with requirements management tool and HP-ALM. Experience defining and managing business rules leveraging rules engine technology. Experience working in an Agile and/or iterative development environment.  A master’s degree, MBA or equivalent is preferred.

The physical demands described here are representative of those that must be met by an associate to perform the essential duties and responsibilities of the position successfully.  Requirements may be modified to accommodate individuals with disabilities.

The associate is primarily seated while performing the duties of the position.  Occasional walking or standing is required.  The hands are regularly used to write, type, key and handle or feel small controls and objects.  The associate must frequently talk and hear.  Weights of up to 25 pounds are occasionally lifted.

Department:  Benefit Admin


Note:  The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.  It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Must be eligible to work in the U.S. without Sponsorship

Please visit our website to apply:

Please apply before:  August 26, 2016

Actual salary will be based on relevant job experience and work history.


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