Program Manager Clinical, Senior

Your Role

The Rapid Quality Improvement Team is accountable for quality ratings of the organization and the development and execution of targeted, quality improvement initiatives in support of the commercial medical groups, hospitals, affiliated providers, and our Covered California membership. The Program Manager Clinical, Senior will report to the Manager, Program and Project Management. In this role you will be responsible in the commercial line of business for the development and execution of targeted, quality improvement initiatives with our external provider group partners to achieve improved outcomes in HEDIS measures. You will partner with other lines of business and align quality interventions to the organizational strategies for HEDIS, QRS, CAHPS, and our Covered California membership.  The Clinical Program Manager will manage to data driven outcomes and targets helping to facilitate getting provider data into our Blue Shield systems.        

Your Work

In this role, you will:

  • Direct small-scale, complex programs/projects that may involve multiple internal and external stakeholders 
  • Manage the development and implementation of process of company’s projects involving departmental or cross-functional teams focused on delivery of new or existing internal/external programs and/or products
  • Be responsible for assembling a project team, assigning, and monitoring work of team members and providing guidance and leadership
  • Develop the program, integrated program plan, resource plan, contingency plan, and related project management artifacts 
  • Define and track program milestones while developing, maintaining, and reporting on an overall integrated delivery plan
  • Be responsible for planning, execution, and evaluation of large and complex program initiatives to improve quality performance in the commercial line of business
  • Educate and work with internal and external partners as needed to identify innovative quality improvement opportunities and adopt improvement actions
  • Demonstrate thought leadership, critical thinking, excellent project management skills, knowledge and experience with program evaluation and consulting skills
  • Perform other duties as assigned by management
  • Manage a portfolio of provider groups and be accountable for key quality measure improvements through building stronger partner relationships and data channels into Blue Shield’s data systems

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!

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