The Blue Shield Promise Health Plan Program and Project Management Office (PMO) is focused on the Medi-Cal line of business and accountable for program and project management initiatives that ensure regulatory and contractual obligations are met, drive growth, and ensure our providers and members have the high-quality experience they deserve. Under the direction of the Senior Manager in the Medi-Cal PMO, the Program Manager, Consultant supports key activities to deliver critical Blue Shield Promise Health Plan outcomes. This role is responsible for developing and managing project plans and deliverables across multiple functional areas and teams within the enterprise. Ensures project schedules, budget, resources, risks and dependencies are appropriately managed to ensure initiative investments achieve Blue Shield Promise strategic and tactical objectives. Works with the Blue Shield Promise Leadership Team, Portfolio Leader, Senior Managers, and Project Managers to understand the business needs and ensure they are appropriately accounted for in the scope, schedule, and budget of portfolio initiatives, and successfully resolves conflicts, as necessary. Ability to work within a fast-paced, highly regulated Centers for Medicare & Medicaid Services (CMS) and Department of Managed Health Care (DMHC) environment with competing priorities and diverse stakeholders. Must be customer-centric, a team player, and adept at building strong relationships with clients and stakeholders. This role is strategic as well as operational, and requires excellent stakeholder engagement and facilitative skills, acutely focus on priorities, be flexible, and assertive to drive accountability and results. The role requires a self-starter with a focus on creative solutioning as well as strong analytical and financial skills.
Responsibilites
Leads and participates in a variety of Medi-Cal strategic and operational initiatives that can have cross-functional and line of business impacts across the enterprise.
Responsible for coordinating with multiple business units (Operations, IT, and Digital) to deliver on Medi-Cal project outcomes.
Responsible for developing and managing project plans and enterprise project development life cycle (PDLC) deliverables including business cases and financial/funding documentation.
Responsible for partnering and supporting business drivers within Blue Shield Promise.
Monitors programs/projects from initiation through delivery and interfacing with internal customers.
Organizes activities and interdepartmental meetings, and facilitates project discussions.
Applies Agile (SCRUM) or Waterfall methodologies to all programs and projects.
Ability to consult with all levels including senior management, make recommendations, and influence decision-making. Leverages cross-functional internal and external relationships to drive initiatives forward.
Proven ability to determine key business issues and risks, and develop effective action plans and implement to successful conclusion.
Build and leverage cross-functional internal and external relationships to drive initiatives.
Understand Medi-Cal areas that align with Blue Shield Promise mission of serving more, such as provider data, eligibility, quality, and enrollment.
Other duties as assigned.
Experience and Qualifications
Typically, requires a college degree or equivalent experience and minimum 7 years of prior relevant experience.
Agile, Six Sigma or Project Management certification strongly preferred.
Excellent project management and organizational skills, with attention to detail.
Medi-Cal knowledge and experience preferred.
Experience developing, managing, and assessing program and project management documentation, and managing projects in Planview.
Highly organized and a critical thinker, ability to understand the operational vision and identify correlating strategic business goals and objectives, ability to constantly adjust and prioritize competing projects, and be results-oriented.
Demonstrated participation and/or knowledge on large-scale cross-functional projects.
Strong negotiation skills and ability to successfully interact with all levels of management.
Knowledge of Blue Shield of CA or similar health care organizational knowledge/experience.
Strong analytical and quantitative skills with ability to use advance features of Excel, PowerPoint, and Word.
Must function extremely well in a face-paced environment and adapt quickly to change. Ability to multitask with multiple deadlines and/or milestone requirements.
Adapts well to change, challenging situations and easily builds trust with others.
Exhibits a "can do" attitude and solution-oriented approach to resolve challenges.
Additional Information
About Company: At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California has been dedicated to transforming health care by making it more accessible, cost-effective, and customer-centric. We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 6,800 employees, more than $20 billion in annual revenue and 4.3 million members. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. We're excited to share Blue Shield of California has received awards and recognition for - LGBT diversity, quality improvement, most influential women in corporate America, Bay Area's top companies in volunteering & giving, and one of the world's most ethical companies. Here at Blue Shield of California, we're striving to make a positive change across our industry and the communities we live in - Join us!
Physical Requirements: Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day. Please click here for further physical requirement detail.
EEO Footer: External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.
