Blue Shield of California · 1 week ago
Program Manager, Principal (Prior Authorization)
California, United States
Full-time
Hybrid
Lead/Staff
10+ years expBlue Shield of California is focused on creating a healthcare system that is affordable and serves the community. The Enterprise Prior Authorization Accountability Program Manager will lead all enterprise-wide prior authorization initiatives, ensuring compliance with regulations while driving operational excellence and cross-functional alignment.
Financial ServicesHealth InsuranceNon Profit
Responsibilities
Operate strategically across the enterprise to ensure projects and programs align with Blue Shield of California’s strategic roadmap while incorporating compliance with federal and state legislation governing Prior Authorization requirements
Participate in enterprise alignment on industry coalitions, including AHIP, on all initiatives to support Prior Authorization processes
Serve as Executive Driver for the Enterprise Prior Authorization Steering Committee, championing governance and cross‑functional execution to streamline Prior Authorization, with a lens on automation and affordability
Consult with all levels of leadership including senior management, make recommendations, and influence decision-making to achieve end-state outcomes
Leverage cross-functional internal and external relationships to drive initiatives forward
Serve as a stakeholder contributing to complex projects and programs spanning across BSC
Develop presentations for senior leadership and committee review
Qualification
Required
Requires a college degree or equivalent experience and minimum 10 years of prior relevant experience
Requires strong knowledge of federal and state regulations
Knowledge of Blue Shield of CA or similar health care organization structure
Technically proficient having broad background in problem solving tools
Knowledge in developing and implementing company-wide, organizational development or process improvement programs
Preferred
Master's Degree in a healthcare field preferred
Knowledge of prior authorization preferred
Company
Blue Shield of California
Blue Shield of California is a health insurance service provider.
5001-10000 employees
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)
Funding
Current Stage
Late StageLeadership Team
Gary Culp
Senior Vice President, Government Markets
Gregory Siebert
Senior Vice President Provider Partnerships & Network Management
Recent News
2026-01-13
Fierce Healthcare
2025-12-15
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