Your Role

The Network Management and Provider Partnerships team is responsible for supporting Enterprise-led mandates and managing all Business-led mandates. The Program Manager, Principal will oversee the intake, review, and impact assessment for all mandates to determine what Network Management teams may be impacted. This role will ensure appropriate representation from impacted network team in cross function mandate requirement and impact assessment meeting and project kick offs. Reporting to the Sr. Director, Provider Services-Network, the Program Manager, Principal leads all business led mandates project management efforts. This includes but is not limited to monitoring and representing the business unit's interests in projects from initiation through delivery, tracking for continuous improvement, and monitoring project milestones through completion to ensure timely compliance.

Your work

In this role, you will:

• Represent Network Management and Provider Partnerships in mandate kick-off and impact assessment collaboration meetings to ensure alignment with other business units
• Leads all business led mandates project management efforts, monitoring and representing the business unit's interests in projects from initiation through delivery
• Work closely with the Mandate Control Group to monitor, track, and assess incoming mandates
• Interpret and summarize requirements outlined in legal memos and other mandate documents
• Coordinate with appropriate business areas to confirm business impacts and outline requirements
• Complete business impacts assessments outlined in mandate statutes including State Assembly and Senate bills, CMS all plan letters, and other DMHC and DHCS requirements
• Monitor and communicate project milestone delivery and potential impacts to cross functional project dependencies
• Develop program status dashboard reporting, monitor, and report on status

Your Knowledge and Experience

• Requires a bachelor's degree or equivalent experience. Master's degree preferred
• Requires 10 years of prior relevant experience
• Experience in healthcare compliance and regulation preferred
• Excellent communication skills, both written and oral, and ability to have difficult conversations, manage stakeholders and tailor communications to varying audience levels
• Ability to lead and influence cross-functional teams, including teams with Senior Leadership involvement or oversight
• Knowledge of Blue Shield of CA or similar health care organization structure preferred
• Knowledge of healthcare mandates and regulations preferred

Pay Range:

The pay range for this role is: $136,400.00 to $204,600.00 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.