Program Manager, Principal

Your Role

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 (Behavioral Health Preventive Care Outcomes) will report to the Sr. Manager/Director of Clinical Quality. In this role you will create and drive the improvement strategy for preventive care outcomes in behavioral health, with a focus on multi-site care, transitions of care, and emerging HEDIS measures of mental health. Additionally, in close partnership with department leadership, you will develop and implement the operational roadmap for care gap closure through 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 depression screening, follow up care after emergency room and hospital utilization, 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 position requires an in-office presence two days per week (eight days per month). The office location options for this role are Oakland, Long Beach, Woodland Hills or Rancho Cordova.

Your Knowledge and Experience

• Requires a bachelor's degree or equivalent experience

• Requires a minimum of 10 years of prior relevant experience

• Requires demonstrated knowledge of Quality Ratings Systems, including HEDIS, hospital, emergency room, behavioral health and CAHPS measurement

• Requires a minimum of 7 years of demonstrated experience in behavioral health systems, workflows and teams

• Requires experience executing improvement initiatives within or with a California based healthplan as well as experience executing member or provider engagement interventions in support of preventive care outcomes and improvement for a diverse member population

• Requires demonstrated experience with annual financial modeling and operational planning in environments of rapid execution as well as demonstrated knowledge of strategic planning and multi-year project and program management

• Requires demonstrated ability to communicate complex ideas simply and succinctly both verbally and in writing, including ability to speak comfortably and extemporaneously to diverse audiences, capable of self-management and exhibits a self-starter attitude as well as demonstrated experience and strong skills assembling presentations for executive audiences, including guiding teams to gather pertinent information, and navigating a variety of presentation formats for various audiences