Program Manager, Senior

Blue Shield of CA; Rancho Cordova (CA); Hybrid; USD 140,000 - 190,000; Full time

Job summary

Blue Shield of CA is seeking a Senior Program Manager to lead the planning and execution of annual HEDIS audit operations within the Clinical Quality Analytics team. You will serve as the primary operational liaison to external HEDIS audit firms and drive timely completion of roadmaps, requests, onsite activities, and cross-functional deliverables.

We look for leaders who empower teams, apply critical thinking, and foster continuous learning.

Qualifications

• Bachelor's degree or equivalent; four additional years of relevant experience in lieu of degree.
• 5+ years of program or project management experience with ownership of cross‑functional deliverables and risk management.
• Strong understanding of project/resource management and enterprise tools.
• Excellent written and verbal communication; ability to influence without authority.
• Experience with HEDIS reporting and NCQA HEDIS compliance audits; liaison to external HEDIS audit firms preferred.

Responsibilities

• Lead planning and execution of annual HEDIS audit operations.
• Serve as primary operational liaison to external HEDIS audit firms.
• Drive timely completion of audit roadmaps, information requests, onsite activities, and cross-functional deliverables.

Skills

Project management

Stakeholder comms

Analytical thinking

Problem solving

Communication skills

Cross-functional leadership

HEDIS audits

Vendor liaison

PMP preferred

Education

Bachelor's degree

High school diploma/ GED + 4 years experience

Job description

Your Role

The Clinical Quality Analytics team oversees clinical quality measurement, HEDIS reporting, and related data and audit operations that support quality performance, accreditation, and regulatory requirements. Reporting to the Director of Clinical Quality Analytics, the Senior Program Manager will lead the planning and execution of annual HEDIS audit operations. This role serves as the primary operational liaison to external HEDIS audit firms and drives timely completion of audit roadmaps, information requests, onsite activities, and cross-functional deliverables.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Knowledge and Experience

• Bachelor's degree or high school diploma/GED with four additional years of relevant experience in lieu of a degree.

• At least 5 years of prior relevant experience in program or project management experience, including ownership of complex cross-functional deliverables, milestone tracking, risk management, and stakeholder communication.

• Solid understanding of project and resource management, business acumen, and experience working in complex delivery environments; familiarity with enterprise project or portfolio management tools.

• Strong analytical, problem-solving, organizational, and written and verbal communication skills; ability to independently drive action and influence stakeholders without direct authority.

• Experience with HEDIS reporting and NCQA HEDIS compliance audits, particularly serving as a liaison to external HEDIS audit firms, strongly preferred.

• Experience coordinating virtual HEDIS onsite audits, audit roadmaps, audit information requests, and secure data exchanges preferred.

• Knowledge of health plan clinical quality operations, supplemental data source processes, and audit documentation practices preferred.

• PMP or other relevant project management certification preferred; not required.

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.