Sr. Manager, Program Development & Operations - Provider Performance Enablement na Blue Shield of California Group
Blue Shield of California Group · Long Beach, Estados Unidos Da América · Hybrid
- Senior
- Escritório em Long Beach
Your Role
The Senior Manager, Program Development and Operations, Provider Performance Enablement provides oversight and direction for the strategy, design, development, and implementation of solutions to support provider and health systems performance enablement. The Senior Manager reports to the Director, Program Development and Operations, Provider Performance Enablement. In this role, you will work with the Director and other Blue Shield of California (BSC) business leaders to identify issues and design, develop, and implement the strategy for all work within the Provider Performance teams (to improve provider performance across BSC). This role strategically sources and identifies internal and external partners to implement the goals and objectives of the Provider Performance Enablement teams. Additionally, this role interfaces across the enterprise, working with Program Managers, Senior Managers, Directors, Senior Directors and Vice President leaders across Healthcare Quality & Affordability, Information Technology, Finance, Actuary, Transformation & Operations, and Portfolio Management Office. Communicating with BSC and external vendor senior leadership, interfacing, and collaborating directly with providers, hospitals, health systems, and other stakeholders is critical.
The Senior Manager leads identification and mitigation of risks, conducts data analysis to measure program effectiveness, and prepares comprehensive reports for key stakeholders. They contribute to process optimization and the development of best practices, while also conducting implementation study to examine factors influencing the adoption and implementation of evidence-based interventions.
The Senior Manager leads the assessment of organizational readiness, provides consultation and training to enhance implementation competence, and engages with diverse stakeholders to ensure the relevance and feasibility of implementation efforts. Monitoring and evaluation, dissemination of findings, and staying informed of current literature and advancements in implementation science are also crucial aspects of this role.
Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.
Responsibilities
Your Work
In this role, you will:
Lead and develop the core operational model and timeline for the implementation of all work supporting the department's success metrics including monitoring and results reporting
Collaborate with stakeholders to define initiative objectives, scope, and success criteria
Define and track key performance indicators (KPIs) to measure the effectiveness and impact of initiatives
Lead the development of detailed project plans, timelines, and resource allocation strategies.
Conduct organizational assessments to identify barriers and facilitators to implementation, including organizational culture, leadership support, resources, and system-level factors
Lead the creation of successful metrics for the Provider Performance Enablement (PPE) department and teams, informed by internal SME's/stakeholders and external (providers) in the required areas of focus - quality, affordability, risk adjustment, utilization management, and operations
Design, develop and maintain all programs, resources and tools supporting the core work of the PPE department
Support the implementation, timeline, and on-going assessment/evaluation plan for the Provider Engagement Strategy
Support and lead the identification of areas for BSC organizational process change and oversee change implementation as required through feedback from SMEs/stakeholders and external providers to increase BSC organizational efficiency and provider trust
Support and lead research to identify new tools and programs to support provider enablement
Support and lead the development of business requirements to build new tools and programs in support of provider performance enablement in partnership leveraging HQA performance capabilities
Implement new tools to support performance enablement (i.e. Provider adoption)
Provide support and oversight for contracting processes and related monitoring of vendors that support provider engagement
Support and lead business case development to support new tools and programs for provider enablement including all programmatic impact and financial analysis and projections
Support the development of an enhanced provider performance reporting platform informed by internal SME's/stakeholders and external (providers). Partner with internal stakeholders to own/drive implementation of platform
Support and guide development of platform updates and enhancements post-launch to ensure platform long-term effectiveness
Monitor platform user experience and identify areas for enhancement
Provide performance insights to inform payment models, contracting and navigation of members to high-value sites of care
Build, manage, and lead a high performing team. Lead a team while fostering a healthy team culture, prioritizing equity and inclusion and providing a great place to work
Serve as a resource and mentor to other Senior Managers and Program Managers as appropriate
Qualifications
Your Knowledge and Experience
Requires a college degree or equivalent experience
Requires at least 10 years of prior relevant experience, including 4 years of management experience
Requires healthcare operations leadership experience
Lean Sigma, Six Sigma or experience with business process management, or other quality improvement methodologies preferred
Prior healthcare project and program management experience; PMP certification with experience in Agile project delivery methodology preferred
Exceptional verbal and written communication and program/project management skills, including an ability to communicate effectively at an executive level, with a keen attention to detail
Ability to prioritize and manage work and trade-offs against critical project timelines in a fast-paced environment
Excellent influence and engagement skills in building alignment and accountability without formal ownership or authority over talent resources
Ability to build strong and sustainable trusting relationships and the capability to interact within all levels of the organization, internally and externally
Ability to work cooperatively and strategically in a team environment with all levels of professional, technical, and administrative staff and to integrate resources on a timely and organized basis
Acumen to handle complex situations and multiple responsibilities simultaneously with the urgency of immediate demands on the operations
Strategic thinker who has an eye for detail, is organized, and can manage multiple programs simultaneously
Strong communicator with PowerPoint and storyboarding skills. Ability to present information clearly and concisely to various audiences
Ability to deal with highly confidential information and act as a liaison between the business leaders and other constituencies, both internal and external
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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.
