Your Role

The Medi-Cal Policy and Procedure Management team implements and oversees the policy and procedure management and governance processes for the organization, ensuring sufficient and complete Medi-Cal policies and procedures that adhere to regulatory standards, contractual obligations, and business objectives. The Program Manager, Senior will report to the Director of Medi-Cal Policy and Procedure Management. In this role you will, conduct reviews of policies and procedures to ensure completeness and adherence to internal policy and procedure management and governance processes; assist operational areas, as necessary, with determining ownership of regulatory and business requirements; ensure timely reviews and approvals of policies and procedures; and develop and conduct trainings. Additionally, you will assist in development and implementation of new policy and procedure management and governance processes, as necessary, to meet the needs of the organization.

Your Work

In this role, you will:

• Conduct reviews of policies and procedures.
• Work with operational areas on remediations and enhancement of policies and procedures to ensure adherence to regulatory and business requirements.
• Work with operational areas to ensure timely review, approval and regulatory submission of policies and procedures.
• Support coordination and facilitation of the Medi-Cal Policy and Procedure Governance Committee.

Your Knowledge and Experience

• Requires a bachelor's degree or equivalent experience
• Requires at least 5 years of prior relevant experience
• Requires healthcare experience, preferably in managed care
• Requires Medi-Cal regulatory experience
• Requires experience in policy and procedure development, review, and/or management

Pay Range:

The pay range for this role is: $ 87230.00 to $ 130900.00 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.