Company :

Highmark Inc.

Job Description :

JOB SUMMARY

This job is responsible for leading the accountabilities of the Commercial Sales Markets operational compliance, business performance and strategic positioning as it relates to the Blue Cross Blue Shield Association ( BCBSA ), other Blue Cross Blue Shield ( BCBS ) Plans and the Consortium Health Plans ( CHP ) policies, mandates and pro-competitive strategic actions enacted by the BCBSA board. The incumbent is Highmark's designated "National Account Executive" to the BCBSA , in addition to being Highmark's ambassador with the BCBSA , other BCBS Plans and the CHP on Highmark Commercial Markets strategic initiatives. The incumbent supports all Commercial Sales Markets teams and assures maximize synergy with Finance, Sales Ops, Legal, Product Strategy, Customer Alignment, Provider, Actuary, HM Health Solutions, Health Plan Operations, Government Affairs and Advanced Analytics. This position also supports executive leadership related to interactions with BCBSA and other plans.

ESSENTIAL RESPONSIBILITIES

+ Collaborate with all levels of management and staff from all Commercial Sales Markets to propose relevant Blue solutions and consistent messaging in order to deliver value to internal and external customers; acts as subject matter expert and trusted advisor on the national delivery of Blue commercial group business. This includes clearly communicating the value of BCBSA , CHP and other Blue strategic initiatives. + Responsible for managing the cede negotiations and all aspects of the BCBSA Inter-Plan Program Policies related to ceding for the Pennsylvania and National Sales Markets.

Currently a sizable annual risk of being recalled by home plans, if not administered by Highmark, or without strong corporate relationships with the associated blue plans. + Responsible for the BCBSA and CHP financial Policies for the reimbursement of InterPlan fees when Highmark is the Control/Home Plan and Par/Host Plan. Works closely with Highmark's Actuarial, National Business Finance and InterPlan Sales staffs.

Serves as SME witness on Interplan operations, BCBSA policies and business practices in national and local court cases against Highmark and/or BCBSA ; as such responsible for researching and understanding sufficient knowledge, and articulate such information in court or depositions, or assist senior management and legal counsel in preparing for associated legal matters. + Maintain strong, credible, br To view full details and how to apply, please login or create a Job Seeker account