Blue Cross Blue Shield of Michigan

Serve as liaison between business units and IT to identify and implement technical process improvements and manage system development lifecycle activities. | Requires at least three years of relevant technical or business experience, cross-functional team management, a bachelor's degree, and strong analytical skills. | Perform technology functions to include but not limited to business and systems analysis, application development and process improvement. Serve as a liaison between the business area and the IT organization when needed. Identify, document and communicate system and process changes necessary to improve system and operational performance measures.  Possess an in-depth knowledge of line of business while contributing to the identification, analysis and recommendation of technical process improvement initiatives. Design, create and implement technical solutions. Support complex business processes. * Conduct data gathering and analysis to understand business strategy requirements. Provide direction for short and long-term planning sessions and provide direction to ensure understanding of business goals and direction. * Evaluate ongoing department activity and propose new tools or technologies Assist in the business process redesign and documentation as needed for new technology. * Assist in the application development process for multiple applications to ensure application software is delivered on time and within budget.  Ensure all system development lifecycle processes and standards are followed. * Design, code, test, debug, document, implement and maintain complex business applications. Provide ongoing maintenance of applications. * Provide analytical support related to business applications, infrastructure and technology related activities. * May serve as subject matter expert related to interface problem identification, triage and resolution of complex inquiries. * Discuss users’ needs and determine vulnerabilities or areas of poor performance to boost productivity, efficiency and accuracy in our computer systems. * Develop system solutions by preparing and evaluating alternative workflow solutions.  * Perform release management and end to end testing of system changes.  * Identify, investigate, resolve and escalate problems a needed.  Gather data to support recommendations to address problems.  Procure additional technical assistance to help in problem resolution. * Work as a team member or lead on medium or large process complex improvement initiatives supporting the business customer(s)/services(s). * Analyze and evaluate business requirements and current processes and interfaces to identify gaps and areas of improvement. * Develop process requirements and recommendations and communicate for the implementation of technical business solutions. * Design and develop reports and data delivery to accommodate changing business requirements. * Investigate, resolve and escalate problems.   * Adhere to policies and procedures supporting audits to ensure compliance with regulatory requirements. * Train and educate users on new and existing tools. Coach and transfer knowledge to less experienced team members.  QUALIFICATIONS * Bachelor’s degree in related field preferred. * Three (3) years of relevant technical or business work experience required. * Experience in managing cross functional teams or projects required. * Advanced knowledge preferred in system development life cycle, process design, re-engineering, and organization transformation, Six Sigma, CMMI or ITIL, and computer programming languages. * Basic knowledge of business operations and systems requirement processes. * Strong technical, analytical, systems skills. * Display innovation in identifying, proposing, and overseeing the execution of business solutions.  * Written and verbal communication skills; interpersonal skills. * Ability to provide technical or business guidance to clients, both internal and external. * Ability to work independently, or within a team environment.  * Other related skills and/or abilities may be required to perform this job. *   All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.

Lead and manage complex, multi-workstream projects with cross-functional teams to deliver enterprise solutions. | Experienced in project management with leadership skills, PMP certification preferred, and proficiency in project tools. | IntroductionWith more than 7,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust. OverviewAccountable for and manages the development, implementation and ongoing maintenance of long-term project(s) typically spanning two years or more planning to implementation with relatively more complex scope and deliverables that may impact multiple business unit/function or business critical program. Project scope impacts one or more of the following: process, system, function, product and/or service. Project span across enterprise. Aligns with enterprise initiatives, multi-faceted and strategy. Responsibilities• Monitor progress, produce project status reports, timelines, budget reports, project metrics. • Plan projects, including the concept, design, planning, project scope, cost and benefits, testing, acceptance, implementation and post-implementation review of project deliverables. • Leads cross functional teams comprised of various internal customers and vendor resources. Provide assistance and mentor staff on project management related issues. • Lead complex development initiatives. Manage teams and ensure that project resources are utilized in an effective and efficient manner. Ensure project goals are met or exceeded via the facilitation and resolution of barriers prohibiting the progress on projects. • Recommend and implement process changes to increase project execution performance. Review system and tools to ensure quality and efficient implementation of development and enhancement efforts. • Monitor project risk and consult on mitigation plans. • May provide supervision to others. • Other duties as assigned. Requirements• Bachelor's degree in related field required. • Seven (7) or more years' experience in related field. • Five (5) years' project management experience in health plan operations or related field. • Project Management/ Project Management Certificate (PMP) preferred. • Leadership and/or analytical experience with data, systems, and operations. • Knowledge of program management preferred. • Demonstrated proficiency and experience with project management applications, templates, development tools, and analysis tools required. • Demonstrated knowledge and experience planning and leading high-risk and complex projects. • Knowledge of project management tools and methodologies. • Knowledge of healthcare and/or managed care principles, computer systems, and claims databases. • Extensive experience with analysis including root cause identification and problem solving. • Knowledge of Michigan health care marketplace. • Proficient in current industry standard PC applications and systems (e.g., Access, Excel and Word). • Demonstrated project management skills including the use of continuous quality improvement tools. • Demonstrated competency planning and conducting reports and completing research reports. • Excellent written and verbal communication skills.

Lead and manage complex, multi-workstream enterprise projects with cross-functional teams. | Experienced project manager with PMP certification, strong leadership, and proficiency in project management tools, though healthcare experience is not demonstrated. | IntroductionWith more than 7,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust. OverviewAccountable for and manages the development, implementation and ongoing maintenance of long-term project(s) typically spanning two years or more planning to implementation with relatively more complex scope and deliverables that may impact multiple business unit/function or business critical program. Project scope impacts one or more of the following: process, system, function, product and/or service. Project span across enterprise. Aligns with enterprise initiatives, multi-faceted and strategy. Responsibilities• Monitor progress, produce project status reports, timelines, budget reports, project metrics. • Plan projects, including the concept, design, planning, project scope, cost and benefits, testing, acceptance, implementation and post-implementation review of project deliverables. • Leads cross functional teams comprised of various internal customers and vendor resources. Provide assistance and mentor staff on project management related issues. • Lead complex development initiatives. Manage teams and ensure that project resources are utilized in an effective and efficient manner. Ensure project goals are met or exceeded via the facilitation and resolution of barriers prohibiting the progress on projects. • Recommend and implement process changes to increase project execution performance. Review system and tools to ensure quality and efficient implementation of development and enhancement efforts. • Monitor project risk and consult on mitigation plans. • May provide supervision to others. • Other duties as assigned. Requirements• Bachelor's degree in related field required. • Seven (7) or more years' experience in related field. • Five (5) years' project management experience in health plan operations or related field. • Project Management/ Project Management Certificate (PMP) preferred. • Leadership and/or analytical experience with data, systems, and operations. • Knowledge of program management preferred. • Demonstrated proficiency and experience with project management applications, templates, development tools, and analysis tools required. • Demonstrated knowledge and experience planning and leading high-risk and complex projects. • Knowledge of project management tools and methodologies. • Knowledge of healthcare and/or managed care principles, computer systems, and claims databases. • Extensive experience with analysis including root cause identification and problem solving. • Knowledge of Michigan health care marketplace. • Proficient in current industry standard PC applications and systems (e.g., Access, Excel and Word). • Demonstrated project management skills including the use of continuous quality improvement tools. • Demonstrated competency planning and conducting reports and completing research reports. • Excellent written and verbal communication skills.

Lead cross-functional teams to deliver enterprise technology transformations and manage complex stakeholder environments. | Bachelor's degree and extensive experience managing multi-workstream technology programs, though specific technical skills like SQL and healthcare domain knowledge are not demonstrated. | Perform functions to include but not limited to business and systems analysis, application development and process improvement. Serve as a liaison between the business area and the IT organization when needed. Identify, document and communicate system and process changes necessary to improve system and operational performance measures.  Possess an in-depth knowledge of line of business while contributing to the identification, analysis and recommendation of technical process improvement initiatives. Support highly complex business processes requiring design or integration of technical solutions that may cross multiple functions of the business. Design, create and implement technical solutions. Serve as a lead role.   Business Analysis * Conduct data gathering and analysis to understand business strategy requirements. Provide direction for short and long-term planning sessions and provide direction to ensure understanding of business goals and direction. * Evaluate ongoing department activity and propose new tools or technologies.   Application Development * Assist in the business process redesign and documentation as needed for new technology. Assist in the application development process for multiple applications to ensure application software is delivered on time and within budget.  Ensure all system development lifecycle processes and standards are followed. * Design, code, test, debug, document, implement and maintain complex business applications. Provide ongoing maintenance of applications. * Provide analytical support related to business applications, infrastructure and technology related activities.   Systems Analysis * May serve as subject matter expert related to interface problem identification, triage and resolution of complex inquiries. Discuss users’ needs and determine vulnerabilities or areas of poor performance to boost productivity, efficiency and accuracy in our computer systems. Develop system solutions by preparing and evaluating alternative workflow solutions.  * Perform release management and end to end testing of system changes. * Identify, investigate, resolve and escalate problems a needed.  Gather data to support recommendations to address problems.  Procure additional technical assistance to help in problem resolution.   Process Improvements * Work as a team member or lead on medium or large process complex improvement initiatives supporting the business customer(s)/services(s). * Analyze and evaluate business requirements and current processes and interfaces to identify gaps and areas of improvement. * Develop process requirements and recommendations and communicate for the implementation of technical business solutions.   Other Duties and Responsibilities * Design and develop reports and data delivery to accommodate changing business requirements. Investigate, resolve and escalate problems.  * Adhere to policies and procedures supporting audits to ensure compliance with regulatory requirements. * Train and educate users on new and existing tools. Coach and transfer knowledge to less experienced team members. * Other duties may be assigned.    "Qualifications" * Bachelor's degree in related field preferred. * Five (5) years of relevant technical or business work experience required. * Experience in managing cross functional teams or projects required. * Advanced knowledge preferred in : * system development life cycle * process design, re-engineering, and organization transformation, Six Sigma, CMMI or ITIL * computer programming languages * Basic knowledge of business operations and systems requirement processes. * Strong technical, analytical, systems skills. * Display innovation in identifying, proposing, and overseeing the execution of business solutions. * Written and verbal communication skills interpersonal skills. * Ability to provide technical or business guidance to clients, both internal and external. * Ability to work independently, or within a team environment. * Other related skills and/or abilities may be required to perform this job.   Departmental Preferences: * Proven experience with financial, operational and technical competencies within a payer or healthcare operations environment is preferred. * Proficiency in SQL and relational database design including complex query development, data validation, data modeling and he ability to understand SQL code to comprehend data transformation and business logic is preferred.  * Strong analytical mindset with ability to interpret performance metrics and identify operational improvement opportunities is preferred. * Skilled in cross-functional collaboration, particularly with procurement, Actuary, IT and Finance is preferred. * Comfortable working in fast-paced, matrixed environments with a focus on continuous improvement and measurable outcomes is preferred.   All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.

Lead enterprise-wide experience transformation ensuring stakeholder-centric process redesign across multiple operational functions. | Requires 8+ years in experience design or operational transformation with leadership in complex, regulated environments and AI conversational design knowledge. | Department Summary JOB DESCRIPTION Most transformation programs redesign the process and retrofit the experience. This role exists to make sure that never happens at BCBSM. This role is the experience discipline embedded inside our operational and AI transformation — ensuring that when we redesign how we work, we design it around the people it serves. This is the role for a leader who has spent their career bridging how organizations operate and how stakeholders actually experience that operation. This role has enterprise-wide accountability for experience quality across Claims, Enrollment, Billing, Prior Authorization, Appeals, and Service — the full operational lifecycle of the member relationship. This role influences work owned by multiple functions, including Business Efficiency and Continuous Improvement, Digital Strategy and Automation, Operations, IT, Analytics, AI governance and stakeholder experience teams. • Serve as the embedded experience partner for enterprise process redesign by integrating the stakeholder experience layer directly into BECI-owned process maps and service blueprints. • Bring forward friction points, moments that matter, member and stakeholder journeys, and experience measurement into the redesign process; translate stakeholder insights into actionable hypotheses for process and product teams. • Co-develop experience standards that build lasting capability within process improvement practitioners. • Identify and escalate experience risks prior to implementation, maintain cross-functional visibility into experience impacts across workstreams, and ensure that efficiency gains within individual initiatives do not degrade the broader end-to-end stakeholder experience. • Lead experience quality and conversational design across AI and automation that is embedded in operational workflows, including automated communications, agent-assist tools, and autonomous process steps by defining behavioral guardrails, escalation triggers, and failure-state handling in partnership with digital product teams. • Observe, document, and escalate experience risks across this portfolio through a structured inventory and defined handoff processes, and synthesize those findings into regular reporting for transformation leadership. • Represent the stakeholder experience perspective in governance forums and cross-functional alignment sessions, ensuring material risks surface to decision-makers before they compound. • Partner with Digital Strategy and Automation, Digital Product, and Product Team Enablement to embed experience practices, quality frameworks, and stakeholder validation methods into product team operating models. • Provide operational process context to inform product decisions and ensure digital experiences align with underlying process capabilities. • Support discovery, roadmap planning, and launch readiness to prevent misalignment between digital experiences and operational delivery. Qualifications • Bachelor’s degree in business, health care administration, experience design, service design, human-centered design, information systems, organizational development, or a related field is required. • Minimum of eight (8) years experience leading experience design, service design, customer experience strategy, operational transformation, or a closely related discipline, preferably in a regulated industry such as health care or financial services. • Demonstrated experience working within or alongside process improvement, operational excellence, or business process management disciplines, including Lean Six Sigma environments. • Deep knowledge of service blueprinting, journey architecture, stakeholder validation methods, and experience measurement. • Strong understanding of artificial intelligence, automation, and conversational experience design, including the ability to translate human-centered principles into practical guardrails and standards. • Proven ability to influence cross-functional teams and senior leaders without direct authority, and to operate effectively in complex, matrixed environments. • Strong communication, facilitation, consulting, and change leadership skills required. • Experience working with experience-related regulatory frameworks and measurement systems is preferred. • Prior people leadership experience required. All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability. Candidates are hired on an "at will" basis. Nothing herein is intended to create a contract.

Manage and improve business unit operations, lead teams, and execute projects to achieve organizational goals. | Bachelor's degree, 5+ years experience, leadership and project management skills, strong communication and problem-solving abilities. | IntroductionWith more than 7,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust. Overview Responsible for planning, organizing and managing an assigned business unit. Operate within broad objectives to ensure optimum utilization of resources; adapt business unit plans and priorities to address resource and operational challenges. Evaluate policies, procedures and business unit goals to make decisions and solve problems. Responsibilities • Manage activities of a department including, but not limited to planning, problem solving, staff development and communication. • Manage the evaluation of new and existing business processes to identify areas of opportunity and execute on business unit objectives, supporting continuous improvement. • Lead, direct, evaluate and develop the work of assigned employees. • Responsible for special projects, programs and initiatives to ensure successful delivery of business outcomes. • Provide effective and efficient solutions to complex business problems • Ensure that day to day business unit operations align with organizational objectives. Requirements • Bachelor's Degree in a related field is required. Master's Degree in a related field is preferred. • Five (5) years of experience in a related field is required. • Previous experience leading projects and/or teams is required. • Ability to effectively lead, coach and develop team members. • Ability to work effectively in a team environment. • Strong organizational, planning, analytical, and problem-solving skills. • Working knowledge of corporate organizational structures, including functional responsibilities. • Strong verbal, written communication and interpersonal skills. • Ability to manage multiple priorities concurrently. • Ability to solve practical problems and deal with moving variables in situations with limited standardization and alignment. • Ability to interface and present to all levels of the organization. • Ability to build relationships and work collaboratively with cross-functional teams. Departmental Preferences: • Strong Financial Acumen • Proven Experience in Call Center Operations • Strong Project Management experience

Manage and oversee complex projects including planning, budgeting, risk management, and vendor coordination. | Bachelor's degree, 5+ years project management experience, PMP preferred, strong analytical and communication skills, proficiency with project management tools. | Job Description Accountable for and manages the development, implementation and ongoing maintenance of project(s) with moderate to complex scope and deliverables. Project scope is at least two years planning to implementation and may impact one or more business unit/function. Project scope typically impacts one or more of the following: process, system, function, product and/or service. • Develop detailed project plans and schedules, identify goals, objectives, risks and resource allocation. • Monitor project status for significant deviations in quality, cost or schedule. Interface with various departments, senior management and external individuals providing value and support for continuous improvement. • Support development of project budgets and update, as required. • Coach and mentor team members. • Provide feedback on team performance. • Ensure that expectations are developed, controlled, and executed in a timely manner. • Represent leadership staff at meetings in their absence. • May provide supervision to others. • Other duties as assigned. "Qualifications" • Bachelor's Degree in related field required. • Five (5) or more years' experience in related field. • Three (3) years project management experience in health plan operations or related field • Project Management Professional Certificate preferred. • Leadership and/or analytical experience with data, systems, and operations. • Knowledge of program management preferred. • Excellent analytical, organizational, problem solving, verbal and written communication skills. • Knowledge of project management tools and methodologies. • Ability to work independently, within a team environment and with multiple priorities. • Proficient in current industry standard PC applications and systems (e.g., Access, Excel and Word). • Ability to work closely with the technical support team in understanding and resolving systems issues. • Ability to develop, implement, and monitor policies and procedures. • Other related skills and/or abilities may be required to perform this job. Departmental Summary • Centralizes contract oversight, negotiates terms, and ensures compliance; provides the expertise needed to evaluate vendor performance and manage relationships throughout the project lifecycle. • Supplies standardized project governance, status reporting, risk management, and resource coordination essential for multi‑vendor, multi‑phase initiatives. Handles post‑implementation support, system monitoring, and incident resolution; works closely with vendors to guarantee service level adherence after go‑live. • Works with our finance team to assist with cost tracking, and financial reporting for vendor contracts and expenditures, fiscal responsibility. Provides functional expertise, validates that vendor deliverables meet business requirements, and facilitates user adoption and feedback during post‑implementation phases. • Identifies, assesses, and mitigates risks related to vendor performance and project delivery, supporting robust contingency planning. • Reviews contracts, ensures regulatory compliance, and mitigates legal risks associated with third‑party engagements. Departmental Preferences • Proficiency in tools such as Microsoft Office (ex. Excel, PowerPoint), Power BI, Tableau, or other data visualization platforms is preferred. • Strong communication skills and ability to support both Ad Hoc and recurring presentation and reporting needs for internal and external stakeholders is preferred. All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.

Lead and manage complex, long-term projects impacting multiple business units with cross-functional teams. | Bachelor's degree, 7+ years related experience, 5+ years project management in health plan or related field, proficiency with project management tools, and strong leadership and communication skills. | IntroductionWith more than 7,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust. OverviewAccountable for and manages the development, implementation and ongoing maintenance of long-term project(s) typically spanning two years or more planning to implementation with relatively more complex scope and deliverables that may impact multiple business unit/function or business critical program. Project scope impacts one or more of the following: process, system, function, product and/or service. Project span across enterprise. Aligns with enterprise initiatives, multi-faceted and strategy. Responsibilities• Monitor progress, produce project status reports, timelines, budget reports, project metrics. • Plan projects, including the concept, design, planning, project scope, cost and benefits, testing, acceptance, implementation and post-implementation review of project deliverables. • Leads cross functional teams comprised of various internal customers and vendor resources. Provide assistance and mentor staff on project management related issues. • Lead complex development initiatives. Manage teams and ensure that project resources are utilized in an effective and efficient manner. Ensure project goals are met or exceeded via the facilitation and resolution of barriers prohibiting the progress on projects. • Recommend and implement process changes to increase project execution performance. Review system and tools to ensure quality and efficient implementation of development and enhancement efforts. • Monitor project risk and consult on mitigation plans. • May provide supervision to others. • Other duties as assigned. Requirements• Bachelor's degree in related field required • Seven (7) or more years experience in related field • Five (5) years project management experience in health plan operations or related field • Project Management/ Project Management Certificate (PMP) preferred • Leadership and/or analytical experience with data, systems, and operations • Knowledge of program management preferred • Demonstrated proficiency and experience with project management applications, templates, development tools, and analysis tools required • Demonstrated knowledge and experience planning and leading high risk and complex projects • Knowledge of project management tools and methodologies • Knowledge of healthcare and/or managed care principles, computer systems, and claims databases • Extensive experience with analysis including root cause identification and problem solving • Knowledge of Michigan health care marketplace • Proficient in current industry standard PC applications and systems (e.g., Access, Excel and Word) • Demonstrated project management skills including the use of continuous quality improvement tools • Demonstrated competency planning and conducting reports and completing research reports • Excellent written and verbal communication skills Departmental Preferences • 2 years experience coordinating and leading partnerships with Transformation Office and Performance Office in securing funding for Service Ops projects. • 2 years’ experience working WAVE