Program Manager, Consultant

Your Role

The Health Care Solutions Division is responsible for developing, maintaining, and managing the relationship with Blue Shield's network of physicians, hospitals, ambulatory surgery centers, HMO IPAs, and medical groups. Our team, Network Performance Analysis and Contracts (NPAC) is part of the Network Management and Provider Partnerships department and focuses on provider network performance analysis, reporting, and consulting. The NPAC team is responsible for developing analytics and supporting materials to assist and guide strategic development and maintenance of Blue Shield of California (BSC) and Promise Health Plan's (PHP) network of physicians, hospitals, ambulatory surgery centers, HMO IPAs, and medical groups. The Program Manager, Consultant role will report to the Director, Provider Services-Network. In this role you will provide program management, leadership, guidance, services and support for various strategic, regulatory required, and tactical initiatives and projects. This role will partner closely with the Director and other Network Management stakeholders as well as collaborate with various business units as thought partner and expert.

Your Work

In this role, you will:

• Provide overall program leadership, guidance, and manage all aspects of a given program, including requirements gathering, business case creation, and implementation  
• Develop resourcing strategies to ensure optimum support for projects and for the day-to-day operational activities  
• Lead cross-functional meetings and foster teamwork; drive escalation and resolution of issues, while promoting collaboration and coordination across broad categories of stakeholders   
• Support and coach team within the program, while providing technical expertise in planning, execution, and leadership of program, projects, and initiatives 
• Lead, facilitate, and/or drive cross-functional network initiatives as it relates to the end-to-end process; scope inclusive of business, infrastructure and operational changes needed to support the effort
• Participate and collaborate with cross-functional workgroups; support other internal teams such as Contracting, Provider Partnerships, Delegation Oversight, and Provider Operations in developing strategies for improving overall processes, data integrity, and new mandates/regulatory requirements impacting provider networks
• Support development of presentations/reports for internal and external customers 
• Monitor progress, manage risk, and ensure key stakeholders are kept informed about progress and expected outcomes. Summarize and present findings and recommendations to stakeholders (may include Leadership) 
• Develop monitoring practices and timelines associated with the required reporting

Your Knowledge and Experience

• Requires a Bachelor's degree or equivalent experience
• Requires 7 years of prior relevant experience
• Requires previous project management experience
• Strong knowledge of provider networks and healthcare system
• Strong interpersonal skills, ability to work effectively and build relationships with subordinates, peers, senior-level staff, cross-functional teams
• Ability to lead and influence cross-functional teams, including teams with senior-level leadership involvement or oversight
• Strong analytical, problem-solving, and critical thinking skills
• Ability to navigate ambiguous problems and breakdown complex issues into manageable chunks for structured problem-solving
• Ability to influence and drive decision making among all levels of stakeholders