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Blue Shield of California

California nonprofit health insurance provider

Sr. Manager - Program and Project Management, Pharmacy Operations and Stabilization

Program ManagementUpdated on Nov 13
Full-time$137.7k - $233kHybrid

About the Job

Requirements

  • Requires a bachelor's degree or a high school diploma/GED and four years of additional relevant experience in lieu of a degree.
  • Requires eight years of prior relevant experience.
  • Requires four years of prior people-management experience with direct responsibility for supervising, coaching, and evaluating direct reports.
  • Advanced knowledge of pharmacy operations at the health plan level.
  • Experience driving strategic projects and partnering cross-functionally and with external vendor partners to achieve successful outcomes.
  • Excellent verbal and written communication skills that exhibit a solution-oriented approach.
  • Excellent analytical and problem-solving skills.
  • Demonstrated leadership, project management, and program evaluation skills.

Responsibilities

  • Partner with business drivers to execute sub-portfolio delivery, including schedule, scope, resource management, financials, benefit tracking, knowledge of emerging technologies, and issue/risk management, ensuring successful completion of projects and programs in support of business strategies.
  • Partner with managers to manage intake, Rough Order of Magnitude estimation, and demand/capacity, ensuring projects within the program meet cost, resource, environment, schedule, and other constraints within their domain.
  • Provide oversight and direction for all projects and releases within the sub-portfolio, including schedule, issues/risks, budget, resources, and PPM/PWA adherence.
  • Oversee and manage Program Managers, Project Managers, and Analysts in support of sub-portfolio delivery.
  • Ensure overall program and project delivery, schedule and budget attainment, and effective management of leadership expectations in achieving desired outcomes, results, and deliverables.
  • Provide direction, ownership, and oversight of the end-to-end BSC production stabilization process, including BSC- and vendor-specific incidents, ensuring timely and accurate resolution of issues partially or fully caused by contracted vendors and affiliated companies.
  • Own intake, assignment, direction, and resolution of pharmacy production stabilization issues and solutions affecting the BSC book of business; collaborate with stakeholders at all levels, identify downstream impacts, ensure full remediation without unintended negative consequences, identify issue trends and operational improvement opportunities, and provide expert recommendations to stakeholders and vendors.
  • Ensure all production stabilization incidents have complete documentation covering root cause analysis, impact reports, solution alternatives, decisions, communication plans, and implementation.
  • Oversee and manage activities supporting the Pharmacy Annual Readiness and Command Center team.
  • Oversee and manage activities maintaining the pharmacy business continuity plan, including annual reviews and audits.
  • Oversee and manage Quality Assurance and Testing activities to ensure accurate benefit implementation.
  • Perform other duties as assigned.

About the Company

Blue Shield of California

California nonprofit health insurance provider

Blue Shield of California is a nonprofit health plan provider that offers medical insurance options for individuals, families, and employers within California. It operates as a mutual benefit corporation and maintains a broad network of healthcare professionals and facilities, enabling members to access care and manage claims through an online portal. Its services include preventive care programs and digital health coaching, with prior authorization required for certain medical, surgical, and some prescription drugs to control costs and ensure medical necessity. The company draws a substantial portion of its membership from CalPERS and focuses on delivering stable, affordable access to care within the state. Its goal is to provide members with reliable health coverage, a wide provider network, and tools to manage their health and expenses efficiently.

Company size
5,001-10,000
Company stage
Not listed
Total funding
Not listed
Headquarters
United States
Founded
1939

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