Position Summary
The Manager of BlueCard/Ops Support leads a team of Business Systems Analysts responsible for analyzing operational system automated and manual processes, defining business and technical system strategy, governing platform functionality decisions , and coordinating cross-functional solution delivery. The role requires highly specialized knowledge of healthcare claims adjudication systems, interplan data exchange protocols, and BlueCard and Federal Employee Program (FEP) system environments. The incumbent serves as the senior technical subject matter expert for BlueCard platform operations, guiding system requirements definition, resolving complex technical issues, directing platform functionality decisions, and ensuring the successful delivery of system enhancements in coordination with BCBSA standards and internal technology teams.
Key Responsibilities
- Lead, develop, and manage a team of Business Systems Analysts responsible for claims system analysis, requirements definition, testing execution, and technical solution support — providing expert technical guidance on healthcare claims adjudication logic, data flow design, and BlueCard and FEP platform requirements.
- Oversee project planning activities including scope definition, system integration sequencing, technical dependency mapping, and milestone tracking in partnership with the Program Management Office (PMO).
- Define work assignments, review deliverables, and be accountable for team performance outcomes , ensuring staff technical proficiency and delivery quality across concurrent program workstreams.
- Lead enterprise digital transformation initiatives, including migration of BlueCard ITS platforms to AWS cloud infrastructure - supporting platform modernization efforts and governing system design decisions to ensure scalability, performance, and compliance with enterprise standards.
- Manage the full lifecycle of system and business technical updates encompassing requirements definition, test strategy design, validation protocols, and production deployment oversight across multiple claims processing platforms and interrelated system processes simultaneously.
- Lead enterprise and program-level release management by conducting impact assessments across multi-platform system environments , identifying required system changes and ensuring successful delivery of enhancements across mandate-driven release cycles.
- Oversee system checkout activities during production deployments , coordinate with internal technical, technology and external IT teams to verify functionality, accuracy, and operational readiness, and approving production readiness in coordination with leadership before go-live.
- Serve as the senior technical subject matter expert bridging business operations, systems engineering teams, governance bodies, and external platform vendors to resolve complex system issues, integration failures , and data exchange defects.
- Assess system configurations, data exchange implementations, and platform behaviors to verify conformance with BCBSA national program technical standards and FEP system requirements
- Partner with internal departments and external vendors to maintain alignment between system behavior and business requirements — translating complex technical findings into clearly defined system changes, ensuring compliance with applicable regulatory and operational standards.
- Lead root-cause analysis and resolution of complex production system issues to implement system-level technical corrective actions and ensure platform stability.
- Analyze large-scale transaction patterns, exception volumes, and adjudication anomalies to identify systemic risks and drive strategic system improvements
Identify and oversee the implementation of technical improvements to claims adjudication system design including scaled automation solutions, workflow optimization, and performance enhancements across claims adjudication systems.