Your Role

The Specialty Care Programs team within the Clinical Strategy and Programs department is responsible for managing programs focused on providing high-quality care and services to members when and where they need them. The Program Manager, Principal will report to the Director, Specialty Care Programs. In this role you will contract, design, and implement a new field-based care program and oversee ongoing program operations.

Your Work

In this role, you will:

• Communicate with vendors and providers to support delivery of agreements and services
• Operate at a strategic business level to ensure 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, implement, and oversee complex projects/programs spanning across business areas
• Determine key business issues, develop effective action plans, and implement to successful conclusion
• Design, implement, and oversee program operations for a new program(s)
• Collaborate with other program managers and stakeholders to ensure compliance, audit readiness, and overall program success
• Present to internal and external facing committees and in regulatory audits
• Partner with cross-functional teams to identify trends and drive issues to resolution
• Contribute to Blue Shield of California clinical strategy and execution

Your Knowledge and Experience

• Typically, requires a college degree or equivalent experience and minimum 10 years of prior relevant experience.
• Master's Degree preferred.
• Requires mastery level knowledge of job area typically obtained through advanced education combined with experience. May have deep knowledge of project management.
• Technically proficient having broad background in problem solving tools.
• TQM, Six Sigma certification or Project Management certification preferred.
• Knowledge in developing and implementing company-wide, organizational development or process improvement programs.
• Knowledge of Blue Shield of CA or similar health care organization structure.
• Subject matter expert in sophisticated, best practices organizational development, process improvement or project management processes.
• Strong negotiation skills and ability to successfully interact with all levels of management.
• Vendor management experience preferred.
• Medi-Cal experience preferred.

Pay Range:

The pay range for this role is: $ 136400.00 to $ 204600.00 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

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