Program Manager, Consultant at Blue Shield of California Group
Blue Shield of California Group · Woodland Hills, United States Of America · Hybrid
- Professional
- 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, and affiliated providers and our Covered California and CalPERS membership. The Program Manager, Consultant will report to the Senior Manager, Quality Improvement. In this role you will be accountable to build relationships with internal and external stakeholders. To execute data improvement efforts, incentive strategies, and new improvement tactics to raise HEDIS, QRS, and CAHPS outcomes in partnership with select California providers. To do this, the Program Manager, Consultant is expected to coordinate with internal, cross-functional matrix teams, as well as with executive leadership and staff in external provider organizations. Additionally, the Program Manager, Consultant will perform with little oversight, being responsible for identifying root causes of identified problems, formulating new perspectives and innovative approaches to solve the problems.
Responsibilities
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
Be accountable for independently building strong, collaborative relationships with assigned portfolio of provider organizations and with internal partners
Educate and work with external partners to identify innovation opportunities and adopt improvement actions, including getting the data to flow back into the organization’s data systems
Manage programs from initiation/pilot phase through delivery/spread and monitor for continuous improvement
Serve as a quality outcome (HEDIS, QRS, CAHPS) and data flow expert with internal and external constituents
Demonstrate thought leadership, critical thinking, excellent project management skills, knowledge and experience with program evaluation and consulting skills
Qualifications
Your Knowledge and Experience
Requires a bachelor’s degree or equivalent experience
Requires at least 7 years of prior relevant experience
Strong interpersonal skills and demonstrated ability to build relationships in fast-paced environments
Previous project/program management and process improvement experience required and ideally experience with Agile/Lean philosophies and tools
Proven ability to drive quality outcomes in the face of resistance, to conduct complex negotiations, and to create and maintain structure
Requires clinical work or non-clinical work in healthcare with provider partners working on quality improvements through HEDIS, QRS, CAHPS, for better patient outcomes, required knowledge
Requires willingness and ability to perform a role in a high pressure, high expectation, results-driven environment
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.
