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

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.