Blue Shield Of California

Program Manager, Consultant

Blue Shield Of California$90K — $120K *
Lodi, CA 95240In-Person
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree or equivalent experience required
  • 7 years of relevant experience in Pharmacy or health program management and/or consulting
  • Program management experience essential
  • Preferred knowledge of Blue Shield of California, Medi-Cal, Medicare, and/or Individual and Family Plans (IFP)
  • Ability to thrive in a fast-paced multidisciplinary environment
  • Strong analytical and problem-solving skills

Responsibilities

  • Provide overall program leadership and manage all aspects of programs including requirements gathering and implementation
  • Develop resourcing strategies for project support and daily operations
  • Review program budget variance and handle scope change requests
  • Lead cross-functional meetings to promote collaboration and resolve issues
  • Support and coach project managers, offering technical expertise in planning and execution
  • Manage operational initiatives across government markets, liaising with multiple teams for implementation
  • Coordinate pharmacy RFP responses with Account and Sales Pharmacists
  • Oversee new client implementations, ensuring timely delivery of onboarding requirements
  • Address member and client concerns proactively to enhance the pharmacy member experience
  • Prepare program status reports and presentations for senior leadership

Benefits

  • Hybrid work model requiring in-office attendance two days a week
  • Flexibility for employees living more than 50 miles from an office to work with managers on in-office requirements
  • Collaborative work environment promoting teamwork and support
  • Opportunities to contribute to strategic initiatives like Pharmacy Care Reimagined
Full Job Description
Job Description

Your Role

The Pharmacy Strategy and Operations team provides pharmacy benefit management services and strategies to support Blue Shield of California affordability and membership goals. The Program Manager, Consultant will report to the Sr. Manager, Pharmacy Programs. In this role you will support the Government Markets lines of business and will provide consultant level support for pharmacy programs.

Responsibilities

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
  • Review program budget variance and scope change requests, and participate in the budget-resolution process
  • 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 project managers within the program, while providing technical expertise in planning, execution, and leadership of program, projects, and initiatives
  • Lead operational initiatives across the government markets lines of business working directly with product cycle managers, sales, brokers and internal departments to ensure proper implementation and administration of initiatives and timely updates to member and program materials
  • Partner with the Account and Sales Pharmacists to coordinate and complete competitive pharmacy request for proposal (RFP) responses for the government markets line of business
  • Manage new client implementations by working with clients and service providers to identify onboarding & ongoing requirements and driving stakeholders towards timely delivery
  • Manage the pharmacy member experience by proactively addressing member and client concerns, identifying resolutions or alternative solutions
  • Develop and prepare line of business (LOB) reporting, program status, and other senior level or executive level presentations for 1/1 readiness and other strategic initiatives
  • Support Pharmacy Care Reimagined strategic initiative implementation as appropriate


Qualifications

Your Knowledge and Experience
  • Requires a bachelor's degree or equivalent experience
  • Requires 7 years of prior relevant experience with Pharmacy or health program management and/or consulting
  • Requires program management experience
  • Knowledge of Blue Shield of California, Medi-Cal, Medicare, and/or Individual and Family Plans (IFP) is preferred
  • Ability to work in a fast-paced multidisciplinary environment
  • Excellent analytical and problem-solving skills

Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Please click here for further physical requirement detail.

About Blue Shield Of California

Blue Shield of California is a not-for-profit health plan provider that has been providing Californians with access to high-quality healthcare for over 80 years. The company offers a range of health insurance products and services to individuals, families, and employers. Blue Shield of California is committed to improving the health and wellbeing of its members and the communities it serves. The company is also committed to sustainability and has implemented a number of initiatives to reduce its environmental impact.
Learn more about Blue Shield Of California
Size
7,000 employees
Industry
Founded
1981

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