Blue Shield of California · 9 hours ago
Program Manager, Principal - Portfolio Management
Blue Shield of California is a nonprofit organization committed to transforming healthcare to be more affordable and of higher quality. The Principal Program Manager will lead complex strategic healthcare initiatives, focusing on improving healthcare quality, affordability, and member satisfaction through effective program planning and implementation.
Financial ServicesHealth InsuranceNon Profit
Responsibilities
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
Develop and maintain data driven strategy and operational reporting process in support of the Blue Shield prior authorization function. Analyze data, build control reporting, and communicate changes to all levels of the BSC enterprise
Use data to assess operational performance, identify trends, and guide decision-making
Drive initiatives that lead to better clinical outcomes, cost reduction, and member/provider satisfaction
Contribute to HQA artificial intelligence strategy and make recommendations on areas of potential implementation
Support evolving HQA portfolio and vendor strategy
Qualification
Required
Requires a bachelor's degree or equivalent experience
Requires at least 10 years of prior relevant experience
Requires a minimum of 8 years of demonstrated experience in healthcare operations working for a managed care organization
Requires a minimum of 5 years of intermediate to advanced experience with program and project management
Requires intermediate to advanced experience with SQL and MS Excel
Preferred
Experience with healthcare regulatory research and interpretation preferred
Experience with healthcare code sets (CPT/HCPCS/ICD/DRG, etc.) preferred
Company
Blue Shield of California
Blue Shield of California is a health insurance service provider.
H1B Sponsorship
Blue Shield of California has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2023 (1)
2022 (41)
2021 (20)
2020 (31)
Funding
Current Stage
Late StageLeadership Team
Recent News
2026-01-13
Fierce Healthcare
2025-12-15
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