Program Manager, Consultant- Payment Innovation

Blue Shield of California • Oakland, CA

1d • Hybrid

About The Position

The Payment Innovation team leads the design, development, and implementation of value-based payment models. The Program Manager, Consultant - Payment Innovation will report to the Senior Manager of Payment Innovation. In this role you will be responsible for leading the end-to-end design of new value-based payment models, leading the end-to-end program of payment models current payment models that support Blue Shield’s strategic goals. He/she/they will manage program(s) from initiation through delivery, perform operational responsibilities, and monitor for continuous improvement. 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.

Requirements

• Requires a bachelor’s degree or equivalent experience
• Requires at least 7 years of prior relevant experience

Nice To Haves

• Contract writing experience or experience in drafting documents strongly preferred
• Previous experience in value-based care design including designing value-based payment models or financial models preferred
• Previous experience in designing a program/initiative end-to-end, including conceptual design, implementation planning and execution, and on-going operational support strongly desired
• Knowledge and experience of health insurance business and structure, preferably within a payor preferred
• Desired qualification of experience with aligning disparate stakeholders
• Experience with payor data infrastructure, regulations for various lines of business and contracting preferred

Responsibilities

• Support the design and implement value-based payment models/payment mechanisms spanning across business areas where analysis requires evaluation of intangible variance factors.
• Support contract writing, revisions, and tracking for value-based payment models
• 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 complex projects/programs spanning across business areas
• Determine key business issues, develop effective action plans and implement to successful conclusion
• Conducts market research and literature review on alternative payment models and clinical redesign efforts
• Manage project/program planning to ensure completion of key deliverables and reporting
• Lead cross functional project teams, including defining meeting agenda, lead meetings, capturing meeting notes and follow-up on action items

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1-10 employees