Blue Cross and Blue Shield Association logo

Program Manager, Principal

Blue Cross and Blue Shield Association
  • Lodi, CA
    2 days ago

    Job Description

    Your Role

    The Medi-Cal Actuarial and Finance Analytics team is responsible for rate development, financial oversight, regulatory compliance, and strategic financial analysis. The Program Manager, Principal will report to the Senior Director of Medicare and Medi-Cal Finance Analytics. In this role you will serve as a subject matter expert supporting financial compliance, delegated provider oversight, and regulatory requirements.

    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

    • Requires a bachelor's degree or equivalent experience
    • Requires a minimum of 10 years of prior relevant experience in healthcare finance, program management, compliance, actuarial, consulting, or managed care
    • Knowledge of Medi-Cal managed care, healthcare finance, and regulatory compliance
    • Demonstrated ability to independently interpret complex regulations and translate requirements into actionable business and financial recommendations
    • Strong executive communication and stakeholder management skills, including experience representing organizations with regulators, health plans, providers, and external partners

    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.

    Your Work

    In this role, you will:

    • Lead financial compliance activities related to Medi-Cal regulations, delegated provider oversight, Medical Loss Ratio reporting, and audit readiness
    • Independently evaluate new regulatory requirements, assess financial and operational impacts, and develop recommendations for leadership
    • Consult with and influence all levels of the organization, including senior management, to support strategic and regulatory decision-making
    • Identify key business issues, develop actionable solutions, and drive implementation to achieve successful outcomes
    • Drive process and policies improvements that strengthen financial controls, reduce compliance risk, and enhance regulatory reporting accuracy and timeliness
    • Partner across departments and represent the organization in engagements with external stakeholders

    Your Work

    In this role, you will:

    • Lead financial compliance activities related to Medi-Cal regulations, delegated provider oversight, Medical Loss Ratio reporting, and audit readiness
    • Independently evaluate new regulatory requirements, assess financial and operational impacts, and develop recommendations for leadership
    • Consult with and influence all levels of the organization, including senior management, to support strategic and regulatory decision-making
    • Identify key business issues, develop actionable solutions, and drive implementation to achieve successful outcomes
    • Drive process and policies improvements that strengthen financial controls, reduce compliance risk, and enhance regulatory reporting accuracy and timeliness
    • Partner across departments and represent the organization in engagements with external stakeholders

    Numbers & Facts

    LocationLodi, CA
    IndustryInsurance
    Company Size2,000 to 2,499 employees
    Websitehttps://www.bcbs.com/about-us/careers

    About Company

    At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry. We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.

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