Program Manager, Consultant - Member Experience

Blue Shield of CA; California, Long Beach (MO, CA); On-site; USD 80,000 - 110,000; Full time

Job summary

An established industry player is seeking a Program Manager to enhance member experience within Medicare Advantage systems. This role involves implementing innovative programs and processes to improve member engagement and satisfaction. You will lead market initiatives that directly impact performance metrics, utilizing your expertise in healthcare quality improvement and provider engagement. If you have a passion for driving innovation and continuous improvement in healthcare, this opportunity offers a chance to make a meaningful impact in the lives of members while collaborating with a dedicated team. Join us to help shape the future of Medicare Advantage delivery!

Qualifications

• 7+ years of relevant experience in healthcare and Medicare Advantage.
• Proven track record in leading member experience initiatives.

Responsibilities

• Implement programs to improve member experience in Medicare Advantage.
• Lead initiatives to enhance performance on CAHPS and HOS surveys.

Skills

Healthcare Quality Improvement

Provider Engagement

Medicare Advantage Performance

Data Analysis (CAHPS, HOS, NPS)

Regulatory Knowledge (CMS)

Education

Bachelor's Degree or Equivalent Experience

Job description

Your Role

The Medicare Star Performance team is responsible for achieving sustainable Medicare Advantage and 4 Star performance. The Program Manager, Consultant - Member Experience will report to the Director of Medicare Star Strategy and Performance. In this role, you will implement programs and processes designed to improve member experience within our Medicare Advantage delivery systems. You will also lead market initiatives to address member perceptions and enhance Blue Shield of California's performance on the Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Health Outcomes Survey (HOS). This is a field-based position requiring visits with assigned delivery systems in person.

Your Knowledge and Experience

• Requires a bachelor's degree or equivalent experience
• Requires at least 7 years of relevant experience
• Requires 3+ years of experience in healthcare quality improvement, provider engagement, or Medicare Advantage performance initiatives
• Requires familiarity with CMS regulations and Medicare Advantage programs
• Requires a proven track record of leading successful provider engagement and member experience initiatives
• Requires experience facilitating peer-to-peer learning among providers to drive innovation and continuous improvement
• Requires expertise in analyzing and applying survey data (CAHPS, HOS, NPS) to improve performance