Program Manager, Principal - Medicare PPO
Blue Shield of California • Oakland, CA1d • $137,720 - $232,996 • Hybrid
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Program Manager, Principal - Medicare PPO
Blue Shield of California•Oakland, CA
•$137,720 - $232,996•Hybrid
About The Position
The Program Manager, Principal provides leadership and operational support to advance quality performance across clinical programs and contracted provider groups. This role drives the implementation, oversight, and continuous improvement of quality structures, processes, and outcomes necessary to achieve high performance in Medicare Stars, HEDIS, risk adjustment, preventive care, and value‑based care programs for a PPO product line. This position partners closely with internal teams, including Clinical Quality, Medicare Stars, Product, IT, Finance, Population Health, Clinical Integration, and Medicare Operations—as well as external provider groups to ensure successful execution of quality initiatives and organizational goals. 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
- Leadership and operational support for quality performance.
- Implementation, oversight, and continuous improvement of quality structures, processes, and outcomes.
- Achieve high performance in Medicare Stars, HEDIS, risk adjustment, preventive care, and value‑based care programs for a PPO product line.
- Partnership with internal teams (Clinical Quality, Medicare Stars, Product, IT, Finance, Population Health, Clinical Integration, Medicare Operations) and external provider groups.
- Creative and critical thinking.
- Building and sustaining high-performing teams.
- Achieving results the right way.
- Fostering continuous learning.
Responsibilities
- Provides leadership and operational support to advance quality performance across clinical programs and contracted provider groups.
- Drives the implementation, oversight, and continuous improvement of quality structures, processes, and outcomes necessary to achieve high performance in Medicare Stars, HEDIS, risk adjustment, preventive care, and value‑based care programs for a PPO product line.
- Partners closely with internal teams, including Clinical Quality, Medicare Stars, Product, IT, Finance, Population Health, Clinical Integration, and Medicare Operations—as well as external provider groups to ensure successful execution of quality initiatives and organizational goals.
Benefits
- Opportunities for people to grow – personally, professionally, and financially.
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What This Job Offers
Job Type
Full-time
Career Level
Principal
Education Level
No Education Listed
Job Search Resources
Career Resources
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