Healthcare Operations Director
Blue Cross of Idaho (BCI) has an exciting opportunity for a seasoned Director to lead our Healthcare Operations division with a focus on strategy, data, regulatory alignment, and transformation. This role will drive cross-functional process improvements, innovation, and enterprise-wide initiatives that enhance care delivery, operational efficiency, and member experience. The Director will lead strategic planning, data analytics, regulatory strategy, and innovation initiatives across Healthcare Operations. This includes large-scale transformational projects focused on building core business, technology, and industry expertise to deliver world-class healthcare solutions. This position reports to the VP Healthcare Operations. This role has the ability to be based in a hybrid work location and / or work remotely within a mutually acceptable location. Would need to be in office for in person events.
To be considered for this role, you have :
Required Experience :
- A minimum of 10 years leading enterprise-wide strategic, process, or change initiatives in healthcare.
- Proven track record of implementing end-to-end strategy, tools, training, and communication plans.
- Experience managing large-scale healthcare projects ($500k-$2M+).
- Background as a Practitioner, Mentor, or Thought Leader in healthcare transformation.
- Practical application of methodologies such as Lean, Six Sigma, Agile.
- Experience leading teams of analysts and cross-functional project teams.
Required Education :
Bachelors Degree (with preference in Healthcare, Engineering, Process Design, Performance Technology, Information Technology / Computer Science or Business Administration); or equivalent work experience (Two years work experience is equivalent to one year college)Wed also love it if you had :
Master of Business Administration (MBA) or related field.Certifications in Process Improvement (Lean, Six Sigma, Agile), Change Management, or Project Management.Experience in healthcare payer or insurance industries.Proven success in matrixed environments and agile development teams.Having the following knowledge, skills and abilities will be the foundation of your success :
Knowledge of strategic planning methodologies and performance reporting.Data governance, analytics platforms, and dashboard development.Regulatory frameworks including CMS, NCQA, and state-level compliance.Medicare STAR Rating methodology, including performance domains, data sources, and improvement strategies.Innovation models in healthcare delivery and payer operations.Change management principles and methods.Portfolio, program, and project management tools.General medical and agile terminology.Skills :
Strong interpersonal, negotiation, and conflict resolution skills.Collaborative leadership and partnership-building across departments.Thought leadership in continuous improvement and transformation.Exceptional written and verbal communication.Strategic foresight and organizational awareness.Resilience, adaptability, and problem-solving.Proficiency in Microsoft Office Suite.Ability to :
Lead strategic planning and transformation initiatives.Drive data-informed decisions and performance improvement.Align operations with regulatory requirements and audit readiness.Pilot and scale innovative healthcare solutions.Influence enterprise-wide adoption of best practices.Coach and mentor leaders and staff across the organization.Leadership Expectations
Provide vision and direction for strategic initiatives.Act as a key advisor to business partners and executive sponsors.Promote a culture of innovation, diversity, and continuous learning.Communicate strategic goals and outcomes effectively.Develop and manage departmental budgets and performance metrics.Lead change management efforts and mitigate organizational risk.Foster teamwork, collaboration, and a respectful workplace.