Medicare Star Program Manager, Principal
Company: Blue Shield of California
Location: Rancho Cordova
Posted on: June 13, 2022
|
|
Job Description:
Blue Shield of California's mission is to ensure all
Californians have access to high-quality health care at a
sustainably affordable price. We are transforming health care in a
way that truly serves our nonprofit mission by lowering costs,
improving quality, and enhancing the member and physician
experience. To fulfill our mission, we must ensure a diverse,
equitable, and inclusive environment where all employees can be
their authentic selves and fully contribute to meet the needs of
the multifaceted communities we serve. Our comprehensive approach
to diversity, equity, and inclusion combines a focus on our people,
processes, and systems with a deep commitment to promoting social
justice and health equity through our products, business practices,
and presence as a corporate citizen. Blue Shield has received
awards and recognition for being a certified Great Place to Work,
best place to work for LGBTQ equality, leading disability employer,
one of the best companies for women to advance, Bay Area's top
companies in volunteering & giving, and one of the world's most
ethical companies. Here at Blue Shield of California, we are
striving to make a positive change across our industry and the
communities we live in - join us Your Role The Medicare Star
Program team is accountable for leading the strategy to improve
performance on the Medicare Star HEDIS measures. The Medicare Star
Program Manager, Principal will report to the Senior Manager,
Medicare Star Program. In this role you will be responsible for
leading quality improvement initiatives and building strong
collaborative relationships with external provider group partners
to drive Medicare HEDIS, Part D and CAHPS outcomes. To do this, the
Program Manager, Principal is expected to engage across internal,
cross-functional teams and work with external provider
organizations to identify, develop and manage end-to-end programs
to ensure timely execution of deliverables, that align with
strategic goals and are within budget. Also, the Program Manager,
Principal will help provide overall program leadership for the
Medicare Stars Provider Engagement Strategy. Your Work In this
role, you will: Operate at a strategic business level to ensures
projects/programs are in line with Blue Shield of California
strategic goals Consult with all levels including senior
management, make recommendations, and influence decision-making
Leverage cross-functional internal and external relationships to
drive initiatives forward Plan and implement multiple and complex
projects/programs spanning across business areas Determine key
business issues, develop effective action plans and implement to
successful conclusion Provide steady leadership in the face of
uncertainty, change, and aggressive deadlines common to a rapidly
growing company with an evolving business model Serve as a quality
outcome (HEDIS, Medicare Star, CAHPS) expert with internal and
external constituents Frequently responsible for providing
guidance, coaching, and training to other team members and
employees across the company within area of expertise Lead
cross-functional meetings and foster teamwork; drive escalation and
resolution of issues, while promoting collaboration and
coordination across broad categories of stakeholders Develops and
monitors measurement strategies for large change and improvement
initiatives As part of a broader QI team, influences the business
unit, strategies and objectives Provides input into designing
strategies for alignment with business unit goals and objectives
Establish / apply quality objectives, criteria, standards and
levels using appropriate quality management methods, with
stakeholder input (e.g., key performance indicators, scope
definition) Your Knowledge and Experience Requires a bachelor's
degree or prior relevant experience Requires at least 10 years of
prior relevant experience Master's Degree preferred in a healthcare
field (MPH, MSN, MHA, MSW) is preferred Clinical licensure as a
Registered Nurse (RN/BSN), NP, PA, Dietician, or master's degree
(MSW); or equivalent experience is preferred. Requires at least 5
years of healthcare experience in Quality Management, Utilization
Management, or Case Management Previous project/program management
experience in tracking, planning projects, working with large data
sets and making data - driven analytical decisions required
Extensive experience with Medicare Star Program, Dual Eligible,
Special Needs or Medi-Cal quality improvement requirements
preferred Experience with quality improvement/process improvement
techniques required Experience in the CA delegated model or with
highly integrated clinical delivery systems preferred Intermediate
level of proficiency with MS Excel, Visio, and Power Point Requires
ability to perform up to 10% travel Our Values Honest. We hold
ourselves to the highest ethical and integrity standards. We build
trust by doing what we say we're going to do and by acknowledging
and correcting where we fall short Human. We strive to be our
authentic selves, listening and communicating effectively, and
showing empathy towards others by walking in their shoes
Courageous. We stand up for what we believe in and are committed to
the hard work necessary to achieve our ambitious goals
PDN-9648f448-f89a-4d90-ad7b-b544acdfc4e1
Keywords: Blue Shield of California, Rancho Cordova , Medicare Star Program Manager, Principal, Executive , Rancho Cordova, California
Click
here to apply!
|