Apply on Employer Site

Blue Shield of California · 7 hours ago

Sr. Manager, Program Development & Operations -Provider Performance Enablement

California, United States

Full-time

Hybrid

Senior Level, Lead/Staff

10+ years exp

Blue Shield of California is a nonprofit organization dedicated to transforming healthcare to be more affordable and efficient. The Senior Manager, Program Development and Operations, Provider Performance Enablement will oversee the strategy, design, and implementation of solutions aimed at enhancing provider performance across the organization.

Financial ServicesHealth InsuranceNon Profit

H1B Sponsor Likely

Responsibilities

Lead and develop the core operational model and timeline for the implementation of all work supporting the department's success metrics including monitoring and results reporting

Collaborate with stakeholders to define initiative objectives, scope, and success criteria

Define and track key performance indicators (KPIs) to measure the effectiveness and impact of initiatives

Lead the development of detailed project plans, timelines, and resource allocation strategies

Conduct organizational assessments to identify barriers and facilitators to implementation, including organizational culture, leadership support, resources, and system-level factors

Lead the creation of successful metrics for the Provider Performance Enablement (PPE) department and teams, informed by internal SME's/stakeholders and external (providers) in the required areas of focus - quality, affordability, risk adjustment, utilization management, and operations

Design, develop and maintain all programs, resources and tools supporting the core work of the PPE department

Support the implementation, timeline, and on-going assessment/evaluation plan for the Provider Engagement Strategy

Support and lead the identification of areas for BSC organizational process change and oversee change implementation as required through feedback from SMEs/stakeholders and external providers to increase BSC organizational efficiency and provider trust

Support and lead research to identify new tools and programs to support provider enablement

Support and lead the development of business requirements to build new tools and programs in support of provider performance enablement in partnership leveraging HQA performance capabilities

Implement new tools to support performance enablement (i.e. Provider adoption)

Provide support and oversight for contracting processes and related monitoring of vendors that support provider engagement

Support and lead business case development to support new tools and programs for provider enablement including all programmatic impact and financial analysis and projections

Support the development of an enhanced provider performance reporting platform informed by internal SME's/stakeholders and external (providers). Partner with internal stakeholders to own/drive implementation of platform

Support and guide development of platform updates and enhancements post-launch to ensure platform long-term effectiveness

Monitor platform user experience and identify areas for enhancement

Provide performance insights to inform payment models, contracting and navigation of members to high-value sites of care

Build, manage, and lead a high performing team. Lead a team while fostering a healthy team culture, prioritizing equity and inclusion and providing a great place to work

Serve as a resource and mentor to other Senior Managers and Program Managers as appropriate

Qualification

Healthcare operations leadershipLean Sigma/Six SigmaProject managementPMP certificationAgile project deliveryData analysisStakeholder engagementCommunication skillsTeam leadershipStrategic thinking

Required

Requires a college degree or equivalent experience

Requires at least 10 years of prior relevant experience, including 4 years of management experience

Requires healthcare operations leadership experience

Exceptional verbal and written communication and program/project management skills, including an ability to communicate effectively at an executive level, with a keen attention to detail

Ability to prioritize and manage work and trade-offs against critical project timelines in a fast-paced environment

Excellent influence and engagement skills in building alignment and accountability without formal ownership or authority over talent resources

Ability to build strong and sustainable trusting relationships and the capability to interact within all levels of the organization, internally and externally

Ability to work cooperatively and strategically in a team environment with all levels of professional, technical, and administrative staff and to integrate resources on a timely and organized basis

Acumen to handle complex situations and multiple responsibilities simultaneously with the urgency of immediate demands on the operations

Strategic thinker who has an eye for detail, is organized, and can manage multiple programs simultaneously

Strong communicator with PowerPoint and storyboarding skills. Ability to present information clearly and concisely to various audiences

Ability to deal with highly confidential information and act as a liaison between the business leaders and other constituencies, both internal and external

Preferred

Lean Sigma, Six Sigma or experience with business process management, or other quality improvement methodologies preferred

Prior healthcare project and program management experience; PMP certification with experience in Agile project delivery methodology preferred

Company

Blue Shield of California

Glassdoor3.8

Blue Shield of California is a health insurance service provider.

Founded in 1939

San Francisco, California, USA

5001-10000 employees

https://www.blueshieldca.com

H1B Sponsorship

Blue Shield of California has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2023 (1)

2022 (41)

2021 (20)

2020 (31)