Program Manager, Consultant Medical Care Programs

Employment Type

: Full-Time


: Miscellaneous

Job Summary As a not-for-profit company, our mission says it all: To ensure all Californians have access to high-quality health care at an affordable price. Driving this mission means being an advocate for care. We have supported universal coverage since 2002 and have taken a market-leading stand on affordability by pledging to limit our net income to 2 percent, meaning we will give back all income over 2 percent to our members and the communities we serve. And since 2005, we have donated more than $200 million dollars to the Blue Shield of California Foundation. The Health Care Quality and Affordability team is made up of about 1,000 doctors, nurses, pharmacists, strategists, industry experts and innovators with a single vision - to transform the delivery of health care. Every day, we work together to improve the quality of patient care for our members while lowering health Care costs to ensure all Californians have access to the care they deserve. How do we do it? Through partnership, innovation, and thought leadership. We continue to expand our network of providers to ensure state-wide access to care. We evaluate analytic and digital health tools that simplify care delivery while improving member health status, health care quality and affordability as well as member and provider experience. We provide high-touch services to members from experienced clinical teams. You'll also find us collaborating with our federal and state legislative officials to help shape policy to advance our Blue Shield mission. Responsibilities * Works as part of the Medical Care Programs Markets Support team. * Oversees program management responsibilities for initiatives related to the Medicare line of business with some work in the Medi-Cal space, that span various functional areas within Medical Care Solutions. * This position works closely with multi-disciplinary stakeholders, including compliance, legal, contracting, product, markets, and functional area SME's. * Facilitate meetings, drive decisions, monitor project tasks, escalate/mitigate issues, and proactively report updates and status related to Medicare and Medi-Cal initiatives to leadership. * Represent Medical Care Solutions on Medicare and Medi-Cal markets meetings, relaying information to stakeholders as appropriate. * Help create annual Medicare and Medi-Cal roadmap of initiatives related to Medical Care Solutions. * Help create standardized structure to approach, implement, and manage Medicare and Medi-Cal initiatives within Medical Care Solutions. * Collaborate with markets to tell the value story of Medical Care solutions. Knowledge, Experience, and Education * A minimum of a Bachelors degree or equivalent or 7+ years of experience in a related area such as public health, project management, program management, or health plan required. * 2+ years of Medicare experience. * Master's degree preferred. * Medi-Cal experience. * Program Management experience. * Sales, account management, and business development experience. * Ability to synthesize voluminous information into concise story * Case management and or Utilization Management experience. * Health Plan experience. Additional Information * About Company: At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California 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 6,800 employees, more than $20 billion in annual revenue and 4.3 million members. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. We're excited to share Blue Shield of California has received awards and recognition for - LGBT diversity, quality improvement, most influential women in corporate America, Bay Area's top companies in volunteering & giving, and one of the world's most ethical companies. Here at Blue Shield of California, we're striving to make a positive change across our industry and the communities we live in - Join us! * 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: 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. * Requisition ID: 2100140 * Posting Date: Feb 9, 2021 * Schedule: Full-time

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