Program Manager jobs at Blue Cross & Blue Shield

Your Role The Program Manager Principal, Program Development and Operations, Provider Performance Enablement supports the design, development, and implementation of solutions to support provider and health systems performance enablement. The Program Manager Principal reports to the Director, Program Development and Operations, Provider Performance Enablement. In this role, you will work with the Director and other Blue Shield of California (BSC) business leaders to identify issues and design, develop, and implement work within the Provider Performance teams (to improve provider performance across BSC). The Program Manager Principal will collaborate with stakeholders to define program objectives and develop detailed project plans, ensure adherence to timelines and resource allocation strategies. This role involves building strong relationships with stakeholders and facilitating effective communication among cross-functional teams. The Program Manager identifies and mitigates risks, conducts data analysis to measure program effectiveness, and prepares comprehensive reports for key stakeholders. They contribute to process optimization and the development of best practices, while also conducting implementation science research studies to examine factors influencing the adoption and implementation of evidence-based interventions. The Program Manager assesses organizational readiness, provides consultation and training to enhance implementation competence, and engages with diverse stakeholders to ensure the relevance and feasibility of implementation efforts. Monitoring and evaluation, dissemination of findings, and staying informed of current literature and advancements in implementation science are also crucial aspects of this role.

Your Role The Pharmacy Production Stabilization team provides management and end-to-end oversight of all Pharmacy production stabilization issues, driving issues from identification to resolution within a matrixed environment. The Program Manager, Consultant will report to the Sr. Manager, Pharmacy Production Stabilization. In this role you will lead intake and initial assessment of new pharmacy issues, partner with subject matter experts to perform root cause analysis, identify impacts and potential solution options, develop and drive the summary and action plan including any remediation needed for medium to large issues impacting Pharmacy Strategy and Operations. Working in a matrixed environment, the Program Manager, Consultant will partner with cross-functional teams and external vendor partners to ensure alignment with stakeholders.

Your Role The Clinical Program Manager, Principal in collaboration with the Regional Medical Director and the CMO Team for Commercial Business will be responsible for collaborating with all internal stakeholders and externally facing partners to transform the way health care is delivered, ensuring best-in-class care for all members. Priority is given to delivering on the Quadruple Aim (lower cost care, increased quality, increased member satisfaction and physician satisfaction) with a focus on execution to drive and accelerate improvements in primary care for all patients. This role will report to the Regional Medical Director.

Your Role The Application Services team plays a critical role in enhancing customer and technical collaboration while delivering all application development through a Platform and Technology Product Operation Model. The Technical Delivery Manager will report to the IT Director, Solution & Delivery Lead. In this role you ensure successful delivery of engineering outcomes across platform or technology product teams but coordinating technical scope, timelines, and team velocity. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Role The Advanced Analytics team who is responsible for managing AI at Stellarus. The Senior Manager will report to the Director of Advanced Analytics. In this role you will lead strategic initiatives to enhance enterprise analytics capabilities through automation, AI-driven solutions, and advanced data platforms. This role ensures scalable, secure, and innovative solutions that support organizational goals.. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building, and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Role The 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 CalPERS membership. The Program Manager, 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 CalPERS membership. The Program Manager will manage to data driven outcomes and targets helping to facilitate getting provider data into our Blue Shield systems.

Your Role The Clinical Program Manager, Principal in collaboration with the Regional Medical Director and the CMO Team for Commercial Business will be responsible for collaborating with all internal stakeholders and externally facing partners to transform the way health care is delivered, ensuring best-in-class care for all members. Priority is given to delivering on the Quadruple Aim (lower cost care, increased quality, increased member satisfaction and physician satisfaction) with a focus on execution to drive and accelerate improvements in primary care for all patients. This role will report to the Regional Medical Director.

Your Role The Senior Manager, Governance, Risk, & Compliance (GRC) Program will report to the Senior Director of Enterprise Risk Management. The successful candidate will be responsible for leading and enhancing the GRC Program including business resiliency and compliance with regulatory and contractual requirements. This direct people-leadership requires collaboration with executive leaders, business owners, and external partners to uphold compliant standards and best practices. Key competencies required are GRC technical expertise and knowledge, critical thinking, collaboration, ability to influence others, strong written and verbal communication, efficient time management, and excellent organizational & problem-solving skills.

Your Role The Pharmacy Production Stabilization team provides management and end-to-end oversight of all Pharmacy production stabilization issues, driving issues from identification to resolution within a matrixed environment. The Senior Manager of the Pharmacy Production Stabilization team will report to the Director of Pharmacy Performance. In this role you will be responsible for the management and ownership of the end-to-end activities needed to bring all pharmacy production stabilization issues to full resolution, develop executive level communications and reporting to keep key stakeholders informed of status, and support annual readiness activities. Leading a team of professionals, you will drive processes and business efficiencies in support of our culture of affordability. This position will work closely with the Pharmacy Strategy and Operations team, cross-functionally with other teams within Blue Shield, as well as with our external vendor partners to ensure timely and accurate resolution of pharmacy production stabilization issues. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Role The Behavioral Health Operations Oversight team maintains program integrity and ensures compliance with regulatory and accreditation standards. The Program Manager, Principal, Behavioral Health Audits & Accreditation will report to the Senior Manager, Behavioral Health Audits & Accreditation. In this role you will support Blue Shield's Behavioral Health program through audit and accreditation readiness efforts to meet federal and state requirements.

Your Role The Behavioral Health Network Management team plays a crucial role in Blue Shield of California's (BSC) mission. We are responsible for developing and maintaining all behavioral health provider networks. Our goal is to nurture positive relationships that are essential for offering our members and clients access to high-quality, affordable health care services. The Program Manager, Principal will report to the Sr. Manager of Behavioral Health Contracting. In this role, you will have the opportunity to support BSC's Behavioral Health Facility network. This is a vital function that ensures we continue to meet the needs of our members and uphold the standards of care we are committed to providing. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Role The Quality Improvement Team is accountable for quality ratings and the organization, development, and execution of targeted, quality improvement initiatives in support of commercial medical groups, hospitals, affiliated providers, and our Covered California and CalPERS membership. The Program Manager, Senior will report to the Senior Manager, Quality Improvement. 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 and CalPERS membership. The Program Manager, Senior will build relationships internally and externally, and manage data driven outcomes and targets, helping to facilitate getting provider data into our Blue Shield systems.