BCBS Interplan Operations Manager

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BCBS Interplan Operations Manager manages the day-to-day operations of BCBS programs to ensure accurate, timely, and compliant processing of out-of-network claims and member transactions. Oversees claims routing, pricing, and settlement between Home and Host plans in accordance with BCBS rules. Being a BCBS Interplan Operations Manager leads staff and workflows to meet BCBS performance standards, service level agreements, and audit requirements. Monitors operational metrics and error trends to identify and resolve issues. Additionally, BCBS Interplan Operations Manager ensures compliance with BCBS program policies, mandates, and reporting obligations. Collaborates with claims, membership, and out-of-network stakeholders to resolve escalations and improve processes. Requires a bachelor's degree. Typically reports to a director. The BCBS Interplan Operations Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be a BCBS Interplan Operations Manager typically requires 5 years experience in the related area as an individual contributor. 1-3 years supervisory experience may be required. Extensive knowledge of the function and department processes.