Blue Shield of California

Your Role

The Healthcare Business Operations (HBO) team provides centers of excellence for healthcare business resolution practice. Our team is responsible for transforming how we operate throughout the enterprise and has a significant impact on our spend. The Senior Manager, Operations role will report to the Director of Provider Dispute Resolution in Healthcare Business Operations. In this role you will be accountable for planning and executing the business strategy for Provider Dispute Resolution Operations. Additionally, you will be responsible for implementing the training and quality for this team, working cross departmentally with other Centers of Excellence. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. 

Your Work

In this role, you will:

• Be responsible for multiple team(s), department(s) or functional area(s); drives results aligned with planning, cost management and methods
• Foster a great place to work by clearly communicating mission, vision, goals, roles, and expectations for team members; recognizing top talent and team achievements; building successful working relationships across the organization; ensuring a safe and healthy work environment; delivering the tools, time, and talent needed to succeed
• Own the budget management, resource management, process improvements, and technology changes for the team(s), department(s) or functional area(s) within purview of this role
• Develop and implement annual budget 
• Manage several related projects, often with the intention of improving the organization's performance
• Develop business actions and outcomes to manage across Provider Dispute Resolution Operations including quality, production, performance analysis, and workforce management practices
• Manage service levels, regulatory, and financial performance of a PDR Operations team across multiple locations
• Ensure that performance objectives and outcomes are consistent with external and internal customer expectations and meet competitive benchmarks; routinely integrates customer feedback and competitive information into ongoing planning and operational activities
• Foster a great place to work by clearly sharing mission, vision, goals, roles, and expectations for team members; recognizing top talent and team achievements; building successful working relationships across the organization; ensuring a safe and healthy work environment; delivering the tools, time, and talent needed to succeed.
• Responsible for making moderate to significant improvements in department, by partnering with training and other key stakeholders.

Blue Shield of California’s mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our continued commitment to diversity, equity, and inclusion upholds our values and advances our goal of creating a healthcare system that is worthy of our family and friends while addressing health disparities, promoting social justice, and integrating health equity through our products, business practices, and presence as a corporate citizen.

Blue Shield has received awards and recognition for being a certified Fortune 100 Best Companies to Work, Military Friendly Employer, People Companies that Care, a Leading Disability Employer, and one of California’s top companies in volunteering and giving. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!

Our Values:

• Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
• Human. We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes.
• Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

Our Workplace Model:

Blue Shield of California is dedicated to making work-life balance a reality. Whether you prefer to work in an office or from home, we understand flexibility is more important than ever. That’s why Blue Shield is a hybrid company, offering you the opportunity to decide where you can do your best and most meaningful work.

Two ways of working: Hybrid (our default) and office

• Hybrid – In a business unit approved office a few times per year to 3 days per week, on average
• Office – In a business unit approved office 4+ days a week, on average. If the role you’re applying for is deemed an “Essential Role,” the company has determined that the role can only be performed in a Blue Shield office or in the field and would require your to meet the office worker classification.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Due to the current public health emergency in California, Blue Shield employees are almost all working remotely. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Please click here for further physical requirement detail. 

Equal Employment Opportunity:

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.