JOB DESCRIPTION
Your Role

The Rapid Quality Improvement team is responsible for the development and execution of targeted, quality improvement initiatives in support of the commercial medical groups, hospitals, and affiliated providers to close gaps in care for our members. The Program Manager, Consultant will report to the Senior Manager, Quality Improvement. In this role you will 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 clinical staff in provider organizations. The Program Manager, Consultant will be responsible for participating in project teams and work with external vendors, assigning, and monitoring work of team members and providing guidance and leadership to ensure timely execution of deliverables, that are within budget.

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
• Impart steady leadership in the face of uncertainty, change, and aggressive deadlines common to a rapidly growing company with an evolving business model
• Lead internal and external 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 targeted provider organizations and with internal partners
• Educate and work with external partners and participating practices as needed to identify innovation opportunities and adopt improvement actions
• Manage programs from initiation/pilot phase through delivery/spread and monitor for continuous improvement
• Serve as a quality outcome (HEDIS, QRS, CAHPS) expert with internal and external constituents
• Facilitate data flow between our provider partners and the company’s data systems

QUALIFICATIONS
Your Knowledge and Experience

• Requires a bachelor’s degree or equivalent experience. Master’s degree or clinical licenses preferred
• Requires 7 years of prior relevant experience
• Requires strong interpersonal skills and demonstrated ability to build relationships in fast-paced environments
• Requires previous project/program management experience and ideally experience with Lean philosophies and tools
• Requires 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 and process improvements for better patient outcomes
• Requires willingness and ability to perform a role in a high pressure, high expectation, results-driven environment

Pay Range:

The pay range for this role is: $109,120.00 to $163,680.00 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

ABOUT THE TEAM
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 genuinely 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 continued commitment to diversity, equity, and inclusion upholds our values and advances our goal of creating a healthcare system that is worthy of our family and friends while addressing health disparities, promoting social justice, and integrating health equity through our products, business practices, and presence as a corporate citizen.

Blue Shield has received awards and recognition for being a certified Fortune 100 Best Companies to Work, Military Friendly Employer, People Companies that Care, a Leading Disability Employer, and one of California’s top companies in volunteering and giving. 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 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.

Our Workplace Model:

Blue Shield of California is dedicated to making work-life balance a reality. Whether you prefer to work in an office or from home, we understand flexibility is more important than ever. That’s why Blue Shield is a hybrid company, offering you the opportunity to decide where you can do your best and most meaningful work.

Two ways of working: Hybrid (our default) and office

• Hybrid – In a business unit approved office a few times per year to 3 days per week, on average

• Office – In a business unit approved office 4 days a week, on average. If the role you’re applying for is deemed an “Essential Role,” the company has determined that the role can only be performed in a Blue Shield office or in the field and would require your to meet the office worker classification.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Due to the current public health emergency in California, Blue Shield employees are almost all working remotely. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

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.