Program Manager, Principal

Blue Shield of California•Oakland, CA

23h•$137,720 - $232,996•Hybrid

About The Position

The Clinical Quality [Commercial Populations] team is accountable for the quality ratings achieved for the organization’s Commercial populations, as well as the preventive care strategy and outcomes for Blue Shield of California’s Commercial members. Clinical Quality also manages financial, multi-site, system, and transitions of care risks associated with Quality performance. The Program Manager, Principal (Coordinated Outcomes) will report to the Snr Manager/Director of Clinical Quality. In this role you will create and drive the improvement strategy for preventive care outcomes in coordinated pediatric and adult dental health, with a focus on multi-site care, coordinating care with medical, and emerging HEDIS measures of dental health outcomes and improvements. Additionally, in close partnership with department leadership, you will develop and implement the operational roadmap for care gap closure through the identification, project management and execution of data system improvements, member support interventions, or provider engagement strategies, including but not limited to education, support and remediation activities. Specifically, the role leads annual planning for quality/improvement/equity activities and negotiates resources, workplans and timelines to achieve HEDIS and CAHPS results, as well as state contract requirements related to preventive dental health services, follow up care following emergency care, and equitable health outcomes. The role is accountable for refreshing, executing and evaluating annual plans and strategies that cascade and scale to multiple teams and functions. 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. This person is required to live within 50 miles of the Oakland or Rancho Cordova offices.

Requirements

Must live within 50 miles of the Oakland or Rancho Cordova offices.

Responsibilities

Create and drive the improvement strategy for preventive care outcomes in coordinated pediatric and adult dental health.
Focus on multi-site care, coordinating care with medical, and emerging HEDIS measures of dental health outcomes and improvements.
Develop and implement the operational roadmap for care gap closure through identification, project management, and execution of data system improvements, member support interventions, or provider engagement strategies.
Lead annual planning for quality/improvement/equity activities.
Negotiate resources, workplans, and timelines to achieve HEDIS and CAHPS results, as well as state contract requirements related to preventive dental health services, follow-up care following emergency care, and equitable health outcomes.
Refresh, execute, and evaluate annual plans and strategies that cascade and scale to multiple teams and functions.