Apply on Employer Site

Blue Shield of California · 9 hours ago

Program Manager, Principal

Oakland, CA, United States

Full-time

Hybrid

Senior Level, Lead/Staff

$155K/yr - $233K/yr

10+ years exp

Blue Shield of California is a nonprofit organization focused on creating a sustainable healthcare system. The Program Manager, Principal will lead the improvement strategy for preventive care outcomes in behavioral health, collaborating with leadership to develop and implement operational roadmaps for care gap closure.

Financial ServicesHealth InsuranceNon Profit

No H1B

Responsibilities

Operate at a strategic business level to ensure projects/programs are in line with Blue Shield of California strategic goals

Consult with all levels including senior management, make recommendations, and influence decision-making

Leverage cross-functional internal and external relationships to drive initiatives forward

Plan and implement multiple and extremely complex projects/programs spanning across businesses

Work collaboratively with teams to develop and implement quality targets and assist monitoring and collecting quality measures

Determine key business issues, develop effective action plans and implement to successful quality outcomes conclusions

Be responsible for planning and implementation of cross-functional quality improvement programs aimed at improving preventive mental health care, which will encompass multiple projects, initiatives, functions and specialties and include the evaluation/analysis of complex data, financial inputs as well as intangible variance factors

Coordinate and oversee the delivery of ambitious targets across multiple internal and external project teams of 5 to 10 people, creating structure to coordinate parallel tracks of work and information for rapid decision making

Drive care gap closure and health outcomes in behavioral health sites of care and primary care through Clinical Quality units to maximize improvement and goal achievement

Assist with budget planning as part of the annual budget cycle

Create and execute annual strategies and execution cycles for new and ongoing member interventions in collaboration with internal and external teams and Leadership

Qualification

Quality Ratings SystemsBehavioral Health SystemsOperational PlanningHEDIS KnowledgeFinancial ModelingCommunication SkillsProject ManagementTeam Leadership

Required

Requires a bachelor's degree or equivalent experience

Requires a minimum of 10 years of prior relevant experience

Requires demonstrated knowledge of Quality Ratings Systems, including HEDIS, hospital, emergency room, behavioral health and CAHPS measurement

Requires a minimum of 7 years of demonstrated experience in behavioral health systems, workflows and teams

Requires experience executing improvement initiatives within or with a California based healthplan as well as experience executing member or provider engagement interventions in support of preventive care outcomes and improvement for a diverse member population

Requires demonstrated experience with annual financial modeling and operational planning in environments of rapid execution as well as demonstrated knowledge of strategic planning and multi-year project and program management

Requires demonstrated ability to communicate complex ideas simply and succinctly both verbally and in writing, including ability to speak comfortably and extemporaneously to diverse audiences, capable of self-management and exhibits a self-starter attitude as well as demonstrated experience and strong skills assembling presentations for executive audiences, including guiding teams to gather pertinent information, and navigating a variety of presentation formats for various audiences