We Are:
Accenture is a global professional services company with leading capabilities in digital, cloud, and security. Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Interactive, Technology, and Operations services—powered by the world’s largest network of Advanced Technology and Intelligent Operations centers. Our people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries.
You Are:
A senior delivery leader with deep expertise in Medicare provider networks, Blue Cross Blue Shield (BCBS) implementations, and HealthEdge HealthRules Payor. You bring hands-on experience designing and implementing provider networks that support BlueCard® participation, inter-plan arrangements, and complex Medicare contracting models.
As a Senior Manager, you will own provider network strategy and execution across large-scale BCBS and Medicare implementations, serving as a trusted advisor to clients while leading high-impact delivery teams within Accenture Health & Public Service Technology.
Key Responsibilities:
Provide end-to-end leadership for Medicare provider and supplier network implementation within HealthRules Payor, including BCBS-affiliated plans
Lead design efforts supporting BlueCard® provider networks, ensuring accurate cross-plan participation and claims readiness
Own provider network strategy and setup, including:
Suppliers (TINs), practitioners, practitioner roles, and supplier locations
Provider networks aligned to BCBS and BlueCard participation rules
Medicare provider contracts, reimbursement structures, and fee schedules
Translate BCBS, BlueCard, and Medicare regulatory requirements into scalable HealthRules configuration solutions
Ensure HealthRules business rules integrate seamlessly with enterprise claims, billing, and downstream operational systems
Advise configuration, testing strategy, and documentation for HealthRules Payor and Designer components
Partner with Functional, Integration, Data, and Testing leads to ensure cohesive, end-to-end delivery across complex workstreams
Serve as a primary client adviser for BCBS provider network and BlueCard-related topics, guiding decision-making and issue resolution
Proactively identify and mitigate risks related to provider network setup, BlueCard compliance, and Medicare claims impacts
Contribute to practice growth, delivery assets, and capability development within Accenture’s Medicare and payer technology practice.
Travel may be required for this role. The amount of travel will vary from 0 to 100% depending on business need and client requirements.