Program Manager, Senior

BSC • Los Angeles, CA

92d

About The Position

The Quality Improvement Team is accountable for quality ratings and the organization, development, and execution of targeted, quality improvement initiatives in support of commercial medical groups, hospitals, affiliated providers, and our Covered California and CalPERS membership. The Program Manager, Senior will report to the Senior Manager, Quality Improvement. In this role you will be responsible in the commercial line of business for the development and execution of targeted, quality improvement initiatives with our external provider group partners to achieve improved outcomes in HEDIS measures. You will partner with other lines of business and align quality interventions to the organizational strategies for HEDIS, QRS, CAHPS, and our Covered California and CalPERS membership. The Program Manager, Senior will build relationships internally and externally, and manage data driven outcomes and targets, helping to facilitate getting provider data into our Blue Shield systems.

Requirements

• Experience in quality improvement initiatives in healthcare settings.
• Strong understanding of HEDIS measures and quality ratings.
• Ability to manage relationships with external provider groups.
• Data analysis skills to manage outcomes and targets.

Nice To Haves

• Experience with Covered California and CalPERS membership programs.
• Familiarity with QRS and CAHPS measures.

Responsibilities

• Develop and execute targeted quality improvement initiatives with external provider group partners.
• Achieve improved outcomes in HEDIS measures.
• Partner with other lines of business to align quality interventions with organizational strategies.
• Build relationships internally and externally to support quality improvement efforts.
• Manage data-driven outcomes and targets.

What This Job Offers

• Career Level: Senior
• Number of Employees: 5,001-10,000 employees