Blue Shield of California's mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that truly serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.
To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our comprehensive approach to diversity, equity, and inclusion combines a focus on our people, processes, and systems with a deep commitment to promoting social justice and health equity through our products, business practices, and presence as a corporate citizen.
Blue Shield has received awards and recognition for being a certified Great Place to Work, best place to work for LGBTQ equality, leading disability employer, one of the best companies for women to advance, Bay Area's top companies in volunteering & giving, and one of the world's most ethical companies. Here at Blue Shield of California, we are striving to make a positive change across our industry and the communities we live in - join us!
Your Role
The Risk Adjustment team is hiring a Program Manager, Lead who will develop strategies to encourage members to actively engage in their health journey. . The Member Engagement Program manager will report to the Director of Alternate Site of Care and Member Programs. In this role you will be able to positively impact members lives by offering services to close care gaps and allow BSC to accurately capture the health conditions of our members
Your Work
In this role, you will:
Provide overall program leadership, guidance, and manage all aspects of a given program, including requirements gathering, business case creation, and implementation
Develop resourcing strategies to ensure optimum support for projects and for the day-to-day operational activities
Review program budget variance and scope change requests, and participate in the budget-resolution process
Lead cross-functional meetings and foster teamwork; drive escalation and resolution of issues, while promoting collaboration and coordination across broad categories of stakeholders
Support and coach project managers within the program, while providing technical expertise in planning, execution, and leadership of program, projects, and initiatives
Partner with risk adjustment teams and Health Solutions Quality team to design strategies that promote member engagement to manage health conditions
Proactively drives contracting with the vendor and Global Business Services
Proactively assists vendor management efforts around in-home programs and coordinates with the Medicare Risk Adjustment and Commercial Risk Adjustment teams
Knowledgeable about healthcare-related governmental regulations, procedures, and requirements. Continuous learning as additional information is released
Your Knowledge and Experience
Requires a bachelor's degree or equivalent experience
Requires at least 7 years of prior relevant experience
Must have excellent interpersonal, verbal and written communication and presentation skills
Demonstrated ability to collaborate with other cross-functional areas to meet objectives.
Shown successful ability to manage projects/timelines to achieve successful outcomes.
Strong proficiency with MS Office (Excel, Word, PowerPoint and Visio)
Excellent organization skills and high attention to detail
Our Values
Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short
Human. We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes
Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals
Additional Information
About Company: o About Blue Shield of California: For more than 80 years, Blue Shield 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 7,500 employees, more than $21 billion in annual revenue and 4.5 million members. The company has contributed more than $500 million to the Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield is headquartered in Oakland, California with 21 additional locations including Sacramento, Los Angeles, and San Diego. o Our Benefits: At Blue Shield you can expect a comprehensive benefits program that offers choice and flexibility for our diverse workforce. These programs and resources include: Medical, Dental, and Vision plan benefits, 401(k) with employer match, paid time off (PTO), earned sabbatical time, paid nonprofit volunteer time, flexible work program, free online education, tuition reimbursement, a wellness reimbursement program, 12 weeks paid parental leave, and more.
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: o EEO Footer: 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. 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. o Accommodations: Blue Shield is committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, services, programs and activities. To request a reasonable accommodation prior to your interview, please contact RehabWest, Inc at (760)759-7500.
