Blue Shield of California
El Dorado Hills, CA, United States
Work At Home, Manager
May 07, 2021
Aug 20, 2021
Senior Manager, Performance Improvement – Senior Markets ','21001OM','At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California has been dedicated to transforming health care by making it more accessible, cost-effective, and customer-centric. We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 6,800 employees, more than $20 billion in annual revenue and 4.3 million members. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. We’re excited to share Blue Shield of California has received awards and recognition for – LGBT diversity, quality improvement, most influential women in corporate America, Bay Area’s top companies in volunteering & giving, and one of the world’s most ethical companies. Here at Blue Shield of California, we’re striving to make a positive change across our industry and the communities we live in – Join us!','!*!Summary
The Senior Manager, Performance Improvement, Senior Markets will define, develop, and implement the end-to-end capabilities required to provide customer and broker experience that is scalable through seamlessly operationalized services including but not limited to Medicare Advantage, Prescription Drug Plans and Medicare Supplement product lines. The Senior Manager, Performance Improvement is a key leader within the Senior Markets Performance Optimization team and his/her efforts will be critical to achieving process improvements realizing increasing operational performance, membership growth and retention goals. The ideal candidate will have demonstrated ability to think creatively for transforming the way we do business into long-term sustainable processes which successfully operationalize changes to create the best member experience for prospects, members, and brokers. A deep experience and understanding of end-to-end internal processes, systems and functions is required to deliver scalable and sustainable successful improvement plan(s). This role reports directly to the Director, Performance Improvement, Sales Operations, and Analysis.
Responsible for establishing process improvements to internal and external policies and procedures to enhance performance outcomes.
Responsible for identifying and driving Senior Market performance optimization near term initiatives and quick hit deliverables.
Responsible for driving readiness activities of new business policies, process optimization and system capabilities through business led initiatives and strategic projects within a matrixed structure of cross functional stakeholder representatives. Functional areas include but are not limited to: Customer Care, Enrollment, Billing and Payments, Appeals and Grievances, Claims, Network Management, Medicare Compliance, Medical Management, Finance, Marketing, Sales, Product, Pharmacy, Specialty, Training, Legal, IT, Digital, reporting and analytics.
Responsible for ensuring cross functional readiness including people, process, and technology when new products, services and capabilities are launched.
Create, track, and deliver change management plans and progress status for changes impacting to stakeholders’ group on a consistent agreed upon milestone, deadline and reporting structure.
Responsible for strategic alignment and integration across projects and programs in support of business unit processes and administrative efficiencies.
Drives alignment between strategic projects, mandates, quality, and business led initiatives to meet or exceed overall growth, retention, and operational goals.
Partners with delivery teams to enable successful market launches of new products, transformational and strategic projects. Influence the enterprise to deliver a best-in-class customer experience through delivery team short term and long-term changes.
Drives resolution to problems and issues that arise requiring detailed information gathering, analysis and investigation including recommendations and immediate decision making.
Create and deliver executive reporting including key performance indicators and risk areas to ensure all responsible business units are aligned and driving towards the same performance, sales, and retention goals.
Creates executive and detailed presentations to various levels of management depending on audience and deliverable.
Responsible for managing a small to mid-sized team consisting of experience professionals not limited to business analyst role(s) with hiring and performance management authority.
May work with other leaders and individual contributors and/or act as a cross-functional leader through other business units.
Other ad hoc duties pertaining to the job.
','!*!Knowledge and Experience
Typically, requires a college degree or equivalent experience and minimum 10-year prior relevant experience, including 4 years of management experience.
Demonstrated experience with the end-to-end implementation of new products or processes improvement through multiple impacted cross functional business units required.
Demonstrated understanding of Medicare Advantage and Medicare Supplement managed care health plan customer needs, including expected service experiences required.
Demonstrated ability to work cross-functionally to define and deliver integrated solutions that provide improved member experience required.
Demonstrated ability to create and deliver change management plans with success measures results required.
Proven ability to apply strategic / systems thinking to end-to-end solution design that align with business unit goals and objectives required.
Demonstrated history of effectively applying business analysis to appropriately prioritize and scope customer-facing improvements.
Demonstrated business readiness experience through process design, requirements inputs, testing and tracking practices to successfully deliver new capabilities to internal and external market facing improvements required; requires practical knowledge in leading and managing the business readiness execution of processes, projects, and tactics.
Demonstrated track record of applying influence without authority to accomplish cross-functional outcomes.
Demonstrated understanding of the end-to-end internal processes, systems and functions involved in delivery of intent of change required.
Experience articulating to various levels of leadership recommendations of changes to drive improvements to for audiences including brokers, sales, and prospective members required.
Experience with process improvement and creation of scalable, automated processes; certified with Lean, Six Sigma, or other process improvement methodologies highly preferred.
Has advanced knowledge and skills including business acumen, financial analysis skills, risk management, delegation skills, critical thinking, and decision-making skills.
Successful candidate will be a team player with the ability to influence and lead cross functional teams and is a subject matter expert.
Demonstrated building and leading a high performing team.
Possess excellent verbal and written skills and strong business judgement with the ability to convey and understand complex ideas required.
Detail-oriented with the ability to work in a fast-paced environment.
Ability to work independently with minimal direction or supervision.
Exhibits can do attitude and solution-oriented approach to resolve challenges.
Proficient in MS Office including MS Word, Visio, PowerPoint, and Excel.
Excellent analytical and problem-solving skills.
This position may require 10-15% travel.
','!*!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. ','!*!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. ','','Program and Project Management','United States of America-California-El Dorado Hills','','Consumer Markets','Full-time','May 7, 2021','External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.','Senior Manager, Performance Improvement – Senior Markets
Blue Shield of California
Website : https://www.blueshieldca.com