Blue Shield of California’s mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that truly serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.
To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our comprehensive approach to diversity, equity, and inclusion combines a focus on our people, processes, and systems with a deep commitment to promoting social justice and health equity through our products, business practices, and presence as a corporate citizen.
Blue Shield has received awards and recognition for being a certified Great Place to Work, best place to work for LGBTQ equality, leading disability employer, one of the best companies for women to advance, Bay Area’s top companies in volunteering & giving, and one of the world’s most ethical companies. Here at Blue Shield of California, we are striving to make a positive change across our industry and the communities we live in – join us!
Your Role
The Senior Markets team is accountable for membership growth, profit and loss, performance optimization, and overall customer experience for the Medicare line of business. The Program Manager, Principal - Medicare will report to the Senior Manager, Strategic Planning and Performance. In this role you will lead end-to-end strategic partnership development and vendor management for Senior Markets. You will play a critical role in developing the growth strategy for our key partners and member retention strategies for existing vendor programs, acting as the primary liaison between Blue Shield and the vendor partner. Additionally, you will lead activities that optimize the performance of Senior Markets, including managing key initiatives aligning to Senior Market’s long-term goals and driving activities related performance management forums, including executive level reporting, meeting materials, and leadership dashboards to drive outcomes.
Your Work
In this role, you will:
- Operate at a strategic business level to ensures projects/programs are in line with Blue Shield of California strategic goals
- Consult with all levels including senior management, make recommendations, and influence decision-making
- Leverage cross-functional internal and external relationships to drive initiatives forward
- Plan and implement multiple and extremely complex projects/programs spanning across business areas
- Determine key business issues, develop effective action plans and implement to successful conclusion
- Strategic Partnership Development and Onboarding: Drive the detailed evaluation of potential strategic partners and leads cross-functional work teams to onboard new partners, including establishing contract business terms and building key processes, documentation, and structure that optimize partnership development, onboarding, and status updates. Perform frequent market research to provide leadership with insights and strategic recommendations, including future partnerships. Supports industry newsletter development, maintenance, and distribution
- Vendor Management: Establish and lead end-to-end vendor management activities, including but not limited to building detailed governance model and communication plan and identifying and implement process improvements that optimize member experience. Recommends effective action plans based on key business issues and implement to successful conclusion
- Monitor and Optimize Performance: Lead end-to-end cross-functional preparations for Monthly/Quarterly Business Reviews and Senior Markets performance management forums, including aggregating and preparing information and meeting materials, executive reporting. Develop and operationalize tools and processes to monitor and optimize Line of Business operating model activities working with cross-functional business partners. Collaborate cross-functionally and facilitate the ongoing support for an overall Senior Markets Performance Management System, to include identification of key metrics, goals, objectives and reporting to senior leadership. Recommend effective action plans based on key business issues and implement to successful conclusion. Ensure that end-to-end operating model processes are tightly integrated, detailed, measurable and executable
- Special Projects: Go-to for special assignments and projects that support Medicare growth, profitability, compliance, etc.
Your Knowledge and Experience
- Requires a bachelor’s degree or equivalent experience
- Requires at least 10 years of prior relevant experience
- Medicare experience and proven successful vendor management experience highly preferred, and project management and business planning experience required
- Proven experience and ability to collaborate with and influence team members of all-levels functioning in a matrix environment
- Experience in managing highly visible, complex, cross-functional programs or projects in a fast-paced environment and proven success with completing high priority and/or highly sensitive projects on time and on budget
- Demonstrated strengths at thriving in highly ambiguous and evolving environments, as well as high profile, urgent situations
- Highly organized, analytical, and employs critical thinking and excellent communication skills, both written and oral at the executive and management levels. Demonstrated strengths at thriving in highly ambiguous and evolving environments, as well as high profile, urgent situations Financial/ Data analysis experience to provide insights and recommended actions
Our Values
- Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short
- Human. We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes
- Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals