Program Manager, Consultant - Member Experience

Blue Shield of CA; California, Los Angeles (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. In this pivotal role, you will spearhead initiatives aimed at improving provider engagement and member perceptions. Your expertise in healthcare quality improvement and familiarity with CMS regulations will be crucial in driving performance enhancements. This field-based position involves direct interaction with delivery systems, providing you the opportunity to make a tangible impact. Join a forward-thinking organization committed to delivering high-quality healthcare and improving member satisfaction.

Qualifications

• 7+ years of experience in healthcare quality improvement and provider engagement.
• Expertise in analyzing survey data to drive performance improvement.

Responsibilities

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

Skills

Healthcare Quality Improvement

Provider Engagement

Medicare Advantage Performance Initiatives

Data Analysis (CAHPS, HOS, NPS)

Education

Bachelor's Degree

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 be responsible for leading 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 and will require 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 prior 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 in facilitating peer-to-peer learning opportunities among providers to drive innovation and continuous improvement
• Requires expertise in analyzing and applying survey data (CAHPS, HOS, NPS) to drive performance improvement