Sr. Manager, Program and Project Management - Population Health Management

at  Blue Shield of California

YOUR WORK

In this role, you will:

• Spearhead efforts to establish a strong governance structure around Population Health Management organization.
• Oversee and manage a team of Project/Program managers and Data Analysts to support the delivery of critical Population Health Management priorities
• Support business readiness activities to help stand-up/enhance Population Health Management architecture
• Collaborate with key matrix leaders and teams such as the Office of the Chief Medical Officer, Health Equity office etc. to develop a unified and cohesive vision for Population Health Management
• Design performance metrics in line with population health programming
• Analyze best practices for population management and generate ideas to improve operational efficiency within the Population Health Management organization
• Develop comprehensive updates for executive leadership addressing potential opportunities, risks, contingencies, and/or course direction recommendations
• Actively participate in the Population Health Management leadership meetings, providing insight and guidance on strategic initiatives, ensuring population health objectives align with the organization’s overall goals.
• Accountable for performing quality control analysis on Population Health Management deliverables due to Department of Health Care Services and other regulatory bodies
• Provide year-round Audit readiness support to Population Health Management teams and assist with Corrective Action Plan remediation.
• Work collaboratively with compliance leaders to maintain compliance with all applicable federal, state, and local legal and regulatory requirements. Meet compliance requirements and standards
• Stay abreast on relevant local, state, and federal policies
• Any other assigned duties
• Coordinate with cross-functional teams, including Analytics, Care Management, Quality, and Network Management to leverage data insights and optimize outcomes

QUALIFICATIONSYOUR KNOWLEDGE AND EXPERIENCE

• Requires a bachelor’s degree or equivalent experience
• Requires at least 10 years of prior relevant experience in regulatory research and knowledge of Medi-Cal, relevant laws, regulations, industry standards and best practices. Including 4 years of management experience.
• Ability to provide highly complex in-depth analysis and interpretation of data related to member enrollment and eligibility, community health and health equity and provide insights to solve business problems preferred.
• Demonstrated expertise in navigating large and complex organizations and successfully managing relationship building dynamics and processes within a highly matrixed environment.
• Progressive project and/or program management experience and knowledge in leading and managing the execution of processes, projects and tactics within an area.
• Ability to understand strategies, generate ideas and follow through on tactical execution.
• Excellent analytical and problem-solving skills.
• Strong negotiation skills and ability to successfully interact with all levels of management.
• Knowledge of Health Insurance Operations and broad knowledge of the industry.Excellent interpersonal and communication skills and proven ability to work effectively and drive results with all organizational levels (consult with executives, collaborate cross-functionally with internal clients and coaching at all levels of the organization).

PHYSICAL REQUIREMENTS:

Office Environment - roles involving part to full time schedule in Office Environment. Due to the current public health emergency in California, Blue Shield employees are almost all working remotely. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

JOB DESCRIPTIONYOUR ROLE

The Sr. Manager, Governance, of Population Health Management will report to the Sr. Director of Population Health Management. This role will help establish a strong governance structure and ensure key Population Health Management functions related to regulatory submissions, performance metrics, business readiness etc. are tracking to expectations, and aligning well with enterprise-wide priorities. 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.

In this role, you will:

• Spearhead efforts to establish a strong governance structure around Population Health Management organization.
• Oversee and manage a team of Project/Program managers and Data Analysts to support the delivery of critical Population Health Management priorities
• Support business readiness activities to help stand-up/enhance Population Health Management architecture
• Collaborate with key matrix leaders and teams such as the Office of the Chief Medical Officer, Health Equity office etc. to develop a unified and cohesive vision for Population Health Management
• Design performance metrics in line with population health programming
• Analyze best practices for population management and generate ideas to improve operational efficiency within the Population Health Management organization
• Develop comprehensive updates for executive leadership addressing potential opportunities, risks, contingencies, and/or course direction recommendations
• Actively participate in the Population Health Management leadership meetings, providing insight and guidance on strategic initiatives, ensuring population health objectives align with the organization’s overall goals.
• Accountable for performing quality control analysis on Population Health Management deliverables due to Department of Health Care Services and other regulatory bodies
• Provide year-round Audit readiness support to Population Health Management teams and assist with Corrective Action Plan remediation.
• Work collaboratively with compliance leaders to maintain compliance with all applicable federal, state, and local legal and regulatory requirements. Meet compliance requirements and standards
• Stay abreast on relevant local, state, and federal policies
• Any other assigned duties
• Coordinate with cross-functional teams, including Analytics, Care Management, Quality, and Network Management to leverage data insights and optimize outcome