Program Manager, Consultant at Blue Shield of California
Oakland, CA 94607, USA -
Full Time


Start Date

Immediate

Expiry Date

19 Nov, 25

Salary

0.0

Posted On

19 Aug, 25

Experience

7 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Clinical Support

Industry

Hospital/Health Care

Description

YOUR WORK

In this role, you will:

  • Provide dedicated clinical and operational support to primary care practices participating in the Primary Care Reimagined Hybrid and FFS+ payment models.
  • Enhance provider understanding of the models and maximize engagement through strategic partnerships.
  • Address operational issues and provide subject matter expertise to improve financial and clinical performance.
  • Build and maintain novel relationships with physicians based on contract performance.
  • Scale provider-facing clinical support to additional Performance Enablement initiatives beyond payment models, such as Advanced Primary Care designation, practice transformation, and workflow optimization across lines of business.

YOUR KNOWLEDGE AND EXPERIENCE

  • Requires a bachelor’s degree or equivalent experience
  • Requires at least 7 years of relevant prior experience
  • Bachelor’s or Master’s degree in healthcare administration, nursing, or a related field is preferred.
  • Experience in clinical support, healthcare operations, or a related area is preferred.
  • Strong understanding of value-based care models and physician reimbursement preferred.
  • Excellent communication and relationship-building skills.
  • Ability to work collaboratively with a diverse team of healthcare professionals is preferred.

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.

Responsibilities

YOUR ROLE

The Payment Innovation team leads the design, development, and implementation of value based payment models. The Program Manager, Consultant will report to the Senior Manager of Payment Innovation. In this role you will be responsible for working with practices on Value Based Payment models and supporting them in improving patient outcomes.

In this role, you will:

  • Provide dedicated clinical and operational support to primary care practices participating in the Primary Care Reimagined Hybrid and FFS+ payment models.
  • Enhance provider understanding of the models and maximize engagement through strategic partnerships.
  • Address operational issues and provide subject matter expertise to improve financial and clinical performance.
  • Build and maintain novel relationships with physicians based on contract performance.
  • Scale provider-facing clinical support to additional Performance Enablement initiatives beyond payment models, such as Advanced Primary Care designation, practice transformation, and workflow optimization across lines of business
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