Senior Consultant - National Markets

Location: Remote, work from home in Pennsylvania, United States

Company

hirify.global provides health insurance and manages commercial markets in collaboration with Blue Cross Blue Shield organizations and industry partners.

What you will do

• Lead operational compliance, business performance, and strategic positioning for Commercial Sales Markets in relation to BCBSA, BCBS Plans, and Consortium Health Plans.
• Manage cede negotiations and Inter-Plan Program Policies for Pennsylvania and national sales markets.
• Oversee financial policies for InterPlan fee reimbursement and collaborate with actuarial, finance, sales, legal, provider, and operations teams.
• Research and explain InterPlan operations, BCBSA policies, and business practices for court cases, depositions, and legal preparation.
• Review and recommend policy changes involving BlueCard fees, ceding, networks, and other strategic commercial initiatives.
• Represent hirify.global in BCBSA and CHP workgroups and support senior leadership with national market problem-solving.

Requirements

• Bachelor's degree in Business Administration or Health Care Management, or six years of progressive interplan, consultative, or cede experience in lieu of a degree.
• Five years of experience with BCBSA Inter-Plan Programs and Policies relating to national commercial group business.
• Three years of consultative experience working with BCBSA and BCBS Plans across management and staff levels.
• Three years of project management experience focused on strategic initiatives, negotiating administrative agreements, or defending such agreements.
• Strong project management, negotiation, legal terminology, prioritization, networking, and problem-solving skills.
• Superior knowledge of BCBSA structure, Inter-Plan Programs and Policies, BCBS relationships, and Consortium Health Plans.

Culture & Benefits

• Remote, work-at-home position with an office-based position classification.
• Occasional travel from the office to various work sites may be required.
• Travel requirement is 0%–25%.
• Work involves collaboration with internal teams, BCBS organizations, BCBSA, CHP, legal counsel, and executive leadership.
• Employees must follow HIPAA, privacy, information security, legal, and business conduct requirements.