Blue Shield of California
Program Manager Clinical, Consultant
Blue Shield of California, Oakland, California, United States, 94616
Your Role
The Medical Care Programs team is responsible for managing programs that support members with their health care, drive cost of healthcare savings, and improve quality. The Clinical Program Manager, Consultant will report to the Senior Manager, Medical Care Programs. In this role you will manage a critical, cross-functional cost of healthcare taskforce, focused on a specific employer client. You will be responsible for impacting the cost of healthcare trend by direct intervention and by identifying and driving improvements at the macro and micro level.
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
Provide steady leadership in the face of uncertainty, change, and aggressive deadlines common to a rapidly growing company with an evolving business model
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
Facilitate a cross-functional taskforce with specific cost of healthcare commitments
Research and recommend interventions; identify and drive improvements and actions to significantly impact the cost of healthcare
Maintain detailed documentation of taskforce activities and action items, as well as interventions, outcomes and impacts
Partner closely with analytics teams to develop, analyze and distribute reporting
Coordinate care directly with members, caregivers, providers and facilities
Liaise with analytic and cost of healthcare groups across enterprise to compare trends, share knowledge, and measure outcomes
Your Knowledge and ExperienceRequires a bachelor’s degree or equivalent experienceRequires at least 7 years of prior relevant experienceRequires current California LVN, RN, NP, or PA licensePrefers familiarity with health care data and the health care delivery system in California; health plan or provider experience strongly desiredPrefers Utilization Management experience; Care/Case Management experience also desiredStrong organizational and/or project management skills, consistent ability to “self-start” and take ownership of end-to-end taskforce activitiesExcellent written and oral communication skills, ability to facilitate cross-functional discussions, lead teams through influence to drive actions and outcomesExperience in cost of health care analysis, population health outcomes, and/or program evaluation desiredMS Access database experience desired
Pay RangeThe pay range for this role is: $ 109120.00 to $ 163680.00 for California.
NotePlease 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.
#LI-EB1
The Medical Care Programs team is responsible for managing programs that support members with their health care, drive cost of healthcare savings, and improve quality. The Clinical Program Manager, Consultant will report to the Senior Manager, Medical Care Programs. In this role you will manage a critical, cross-functional cost of healthcare taskforce, focused on a specific employer client. You will be responsible for impacting the cost of healthcare trend by direct intervention and by identifying and driving improvements at the macro and micro level.
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
Provide steady leadership in the face of uncertainty, change, and aggressive deadlines common to a rapidly growing company with an evolving business model
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
Facilitate a cross-functional taskforce with specific cost of healthcare commitments
Research and recommend interventions; identify and drive improvements and actions to significantly impact the cost of healthcare
Maintain detailed documentation of taskforce activities and action items, as well as interventions, outcomes and impacts
Partner closely with analytics teams to develop, analyze and distribute reporting
Coordinate care directly with members, caregivers, providers and facilities
Liaise with analytic and cost of healthcare groups across enterprise to compare trends, share knowledge, and measure outcomes
Your Knowledge and ExperienceRequires a bachelor’s degree or equivalent experienceRequires at least 7 years of prior relevant experienceRequires current California LVN, RN, NP, or PA licensePrefers familiarity with health care data and the health care delivery system in California; health plan or provider experience strongly desiredPrefers Utilization Management experience; Care/Case Management experience also desiredStrong organizational and/or project management skills, consistent ability to “self-start” and take ownership of end-to-end taskforce activitiesExcellent written and oral communication skills, ability to facilitate cross-functional discussions, lead teams through influence to drive actions and outcomesExperience in cost of health care analysis, population health outcomes, and/or program evaluation desiredMS Access database experience desired
Pay RangeThe pay range for this role is: $ 109120.00 to $ 163680.00 for California.
NotePlease 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.
#LI-EB1