BlueCard Program Coordinator

Employment Type

Full-time

Exempt or Non-Exempt

Exempt

Job Summary

**Hybrid Work Environment - Must reside on Oahu **

Pay Range: $68,000 - $133,000,

Note: Individuals typically begin between the minimum to middle of the pay range

The BlueCard Program Coordinator supports the effective administration, coordination, and communication of Inter-Plan Program activities to ensure operational excellence, compliance, and maximum value to HMSA and its members. In partnership with the Inter-Plan Executive and/or designated alternate, this role serves as a key operational resource for Inter-Plan governance, policy interpretation, and program guidance, ensuring alignment with BlueCard program requirements and Inter-Plan Program Manual standards.

The Program Coordinator collaborates with internal departments, other Blue Plans, and the Blue Cross Blue Shield Association to support consistent application of BlueCard and Inter-Plan policies, facilitate issue resolution and escalation management, and provide operational oversight and program updates to leadership in support of strategic and operational objectives.

Minimum Qualifications

• Bachelor's degree and four years of related work experience; or an equivalent combination of education and work experience
• Excellent verbal and written communication skills
• Project and process management skills, with the ability to handle multiple vendors and multiple contracts
• Intermediate level knowledge of Microsoft Office applications. Including but not limited to Word, Outlook, Excel, and Power Point.
  
  
  

Duties And Responsibilities

• Provides and interprets all program guidance internally regarding Inter-Plan Program policies and manuals being accountable for all Inter-Plan governance and policy matters. Monitor and effectively manage inventory of unresolved complex inquiries to provide timely follow-up and accurate resolution of BlueCard claims for HMSA customers.
• Use ITS, Blue2 systems, reference databases, applications, and other tools to research claims questions and inquiries
• Coordinate communication and decisions related to Inter-Plan Programs and other Inter-Plan functions. Lead and distribute BCBSA communications to appropriate individuals within the Plan working with various internal departments. This includes coordinating payment for claims due to dual or more membership.
• Lead and participate to reporting team in reporting requests to produce data and ensure BlueCard clams are being processed and paid accurately. Compile reports about incidents, events, and updates regarding claims processing issues and conflicts. This includes providing recommendations and resolutions.
• Coordinate with multidisciplinary teams; present and influence senior decision makers to secure necessary resources and funding to support National and BCBS Association projects.
• Apply advanced knowledge and service as unit's SME. Participate and lead meetings on workflow changes, identifying training needs, process improvements, and project implementations including our vendor and internal areas
• Complete or participate in corporate training, compliance certification or initiatives as directed by upper management Performs all other miscellaneous responsibilities and duties as assigned or directed.