Program Manager, Principal - Portfolio Management jobs in United States
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Blue Shield of California · 2 hours ago

Program Manager, Principal - Portfolio Management

positionEl Dorado Hills, CA, United States
timeFull-time
remoteHybrid
senioritySenior Level, Lead/Staff
money$155K/yr - $233K/yr
date10+ years exp

Blue Shield of California is a nonprofit organization committed to transforming healthcare to improve quality and affordability. The Principal Program Manager will lead complex strategic healthcare initiatives aimed at enhancing member satisfaction and operational efficiency while collaborating with various stakeholders.

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Responsibilities

Operate at a strategic business level to ensures 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 business areas
Determine key business issues, develop effective action plans and implement to successful conclusion
Develop and maintain data driven strategy and operational reporting process in support of the Blue Shield prior authorization function. Analyze data, build control reporting, and communicate changes to all levels of the BSC enterprise
Use data to assess operational performance, identify trends, and guide decision-making
Drive initiatives that lead to better clinical outcomes, cost reduction, and member/provider satisfaction
Contribute to HQA artificial intelligence strategy and make recommendations on areas of potential implementation
Support evolving HQA portfolio and vendor strategy

Qualification

Healthcare operationsProgram managementProject managementSQLMS ExcelHealthcare regulatory researchHealthcare code setsData analysisLeadership

Required

Requires a bachelor's degree or equivalent experience
Requires at least 10 years of prior relevant experience
Requires a minimum of 8 years of demonstrated experience in healthcare operations working for a managed care organization
Requires a minimum of 5 years of intermediate to advanced experience with program and project management
Requires intermediate to advanced experience with SQL and MS Excel

Preferred

Experience with healthcare regulatory research and interpretation
Experience with healthcare code sets (CPT/HCPCS/ICD/DRG, etc.)

Company

Blue Shield of California

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Blue Shield of California is a health insurance service provider.
dateFounded in 1939
location
San Francisco, California, USA
people-size5001-10000 employees
web-link
https://www.blueshieldca.com

Funding

Current Stage
Late Stage

Leadership Team

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Gary Culp
Senior Vice President, Government Markets
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Gregory Siebert
Senior Vice President Provider Partnerships & Network Management
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