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Care Management Program Manager, Consultant

Company: Blue Shield of CA
Location: Monterey Park
Posted on: March 27, 2020

Job Description:

At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California has been dedicated to transforming health care by making it more accessible, cost-effective, and customer-centric. We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 6,800 employees, more than $20 billion in annual revenue and 4.3 million members. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. Were excited to share Blue Shield of California has received awards and recognition for LGBT diversity, quality improvement, most influential women in corporate America, Bay Areas top companies in volunteering & giving, and one of the worlds most ethical companies. Here at Blue Shield of California, were striving to make a positive change across our industry and the communities we live in Join us!

BUSINESS UNIT: Health Care Quality & Affordability

The Health Care Quality and Affordability team is made up of about 1,000 doctors, nurses, pharmacists, strategists, industry experts and innovators with a single vision to transform the delivery of health care. Every day, we work together to improve the quality of patient care for our members while lowering health Care costs to ensure all Californians have access to the care they deserve.

How do we do it? Through partnership, innovation, and thought leadership.

We continue to expand our network of providers to ensure state-wide access to care. We evaluate analytic and digital health tools that simplify care delivery while improving member health status, health care quality and affordability as well as member and provider experience. We provide high-touch services to members from experienced clinical teams. Youll also find us collaborating with our federal and state legislative officials to help shape policy to advance our Blue Shield mission.

POSITION SUMMARY:

The Care Management Program Manager, Consultant for Medical Care Solutions Care Management department will drive the implementation of care management business process improvements and initiatives. As a key partner, you will also collaborate with others to identify, plan, facilitate, recommend, report, and monitor oversight of new and existing programs to sustain stability and identify areas for course correction. This position will report to the Senior Director of Care Management.

SPECIFIC RESPONSIBILITIES INCLUDE:

* Support the execution of the Care Management program strategy

* Serve as a change agent across Blue Shield Care Management programs, in partnership with enterprise internal stakeholders

* Lead complex projects and programs, from ideation through to cost/benefit results tracking, utilizing program management and business process management best practices

* Project Planning and Implementation

* Facilitates business process improvement

* Maintenance of data analytics in collaboration with training and compliance

* Oversight of CM and SW progression reports

* Information management for audits and projects involving care management practice

* Evaluate opportunities that align with the vision for care management that includes conducting cost/benefit, market, and root-cause analysis

* Assists in the development and organization of workflows

* Provides oversight of data management

* Leads operational business process improvement

* Guide business case development and RFPs for technology and process improvements.

* Participates in assisting lead/manager/director in monitoring care management activities for data gathering purposes

* Drive escalations and resolution of program and project issues

* Provide strong presentation and facilitation skills with the ability to lead cross-functional and vendor discussions

* Demonstrate excellent interpersonal and verbal/written communication skills, strong planning and organizational skills.

* Provide program reporting and status to senior management both verbally and written.

* May act as the business unit liaison to corporate initiatives and projects.

BUSINESS UNIT: Health Care Quality & Affordability

The Health Care Quality and Affordability team is made up of about 1,000 doctors, nurses, pharmacists, strategists, industry experts and innovators with a single vision to transform the delivery of health care. Every day, we work together to improve the quality of patient care for our members while lowering health Care costs to ensure all Californians have access to the care they deserve.

How do we do it? Through partnership, innovation, and thought leadership.

We continue to expand our network of providers to ensure state-wide access to care. We evaluate analytic and digital health tools that simplify care delivery while improving member health status, health care quality and affordability as well as member and provider experience. We provide high-touch services to members from experienced clinical teams. Youll also find us collaborating with our federal and state legislative officials to help shape policy to advance our Blue Shield mission.

POSITION SUMMARY:

The Care Management Program Manager, Consultant for Medical Care Solutions Care Management department will drive the implementation of care management business process improvements and initiatives. As a key partner, you will also collaborate with others to identify, plan, facilitate, recommend, report, and monitor oversight of new and existing programs to sustain stability and identify areas for course correction. This position will report to the Senior Director of Care Management.

SPECIFIC RESPONSIBILITIES INCLUDE:

* Support the execution of the Care Management program strategy

* Serve as a change agent across Blue Shield Care Management programs, in partnership with enterprise internal stakeholders

* Lead complex projects and programs, from ideation through to cost/benefit results tracking, utilizing program management and business process management best practices

* Project Planning and Implementation

* Facilitates business process improvement

* Maintenance of data analytics in collaboration with training and compliance

* Oversight of CM and SW progression reports

* Information management for audits and projects involving care management practice

* Evaluate opportunities that align with the vision for care management that includes conducting cost/benefit, market, and root-cause analysis

* Assists in the development and organization of workflows

* Provides oversight of data management

* Leads operational business process improvement

* Guide business case development and RFPs for technology and process improvements.

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.

Keywords: Blue Shield of CA, Monterey Park , Care Management Program Manager, Consultant, Executive , Monterey Park, California

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