Program Manager, Senior at Blue Shield of California Group
Blue Shield of California Group · Woodland Hills, United States Of America · Hybrid
- Senior
- Office in Woodland Hills
Your Role
The Quality Improvement Team is accountable for quality ratings and the organization, development, and execution of targeted, quality improvement initiatives in support of commercial medical groups, hospitals, affiliated providers, and our Covered California and CalPERS membership. The Program Manager, Senior will report to the Senior Manager, Quality Improvement. In this role you will be responsible in the commercial line of business for the development and execution of targeted, quality improvement initiatives with our external provider group partners to achieve improved outcomes in HEDIS measures. You will partner with other lines of business and align quality interventions to the organizational strategies for HEDIS, QRS, CAHPS, and our Covered California and CalPERS membership. The Program Manager, Senior will build relationships internally and externally, and manage data driven outcomes and targets, helping to facilitate getting provider data into our Blue Shield systems.
Responsibilities
Your Work
In this role, you will:
- Direct small-scale, complex programs/projects that may involve multiple internal and external stakeholders
- Manage the development and implementation of process of company's projects involving departmental or cross-functional teams focused on delivery of new or existing internal/external programs and/or products
- Develop the program, integrated program plan, resource plan, contingency plan, and related project management artifacts
- Validate financial forecasts and provide on-going reconciliation of resources and other related program expenditures
- Define and track program milestones while developing, maintaining, and reporting on an overall integrated delivery plan
Be responsible for planning, execution, and evaluation of large and complex program initiatives to improve quality performance in the commercial line of business
Educate and work with internal and external partners as needed to identify innovative quality improvement opportunities and adopt improvement actions
Demonstrate thought leadership, critical thinking, excellent project management skills, knowledge and experience with program evaluation and consulting skills
Perform other duties as assigned by management
Manage a portfolio of provider groups and be accountable for key quality measure improvements through building strong partner relationships and data channels into Blue Shield’s data systems
Qualifications
Your Knowledge and Experience
Requires a bachelor’s degree or equivalent experience
Requires at least 5 years of prior relevant experience
Knowledge of HEDIS and CAHPS required
Requires previous experience in quality improvement and process/performance improvement, ideally in an outpatient healthcare setting
Requires previous project/program management experience
Requires solid facilitation skills with demonstrated excellence in driving multi-disciplinary and cross-functional teams to consensus
Highly adept computer skills: demonstrated mastery of all MS Office products (including Outlook, Excel, PowerPoint, Word); ability to execute data analysis in Excel to drive root cause analysis and produce PowerPoint presentation deliverables
About Company
About Blue Shield of California
As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.
At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.
To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.
Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!
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 listen and communicate effectively, showing empathy by understanding others' perspectives.
- Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.
Our Workplace Model:
At Blue Shield of California and the Ascendiun Family of Companies, we believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility. As we continue to evolve our workplace model, our focus remains on creating spaces where our people can connect with purpose – whether working in the office or through a hybrid approach – by providing clear expectations while respecting the diverse needs of our workforce.
Two Ways of Working:
- Hybrid (Default): Work from a business unit-approved office at least two (2) times per month (for roles below Director-level) or once per week (for Director-level roles and above). Exceptions:
o Member-facing and approved out-of-state roles remain remote.
o Employees living more than 50 miles from their assigned offices are expected to work with their managers on a plan for periodic office visits.
o For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.
- On-Site: Work from a business unit-approved office an average of four (4) or more days a week.
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.
Equal Employment Opportunity:
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.
