Program Manager, Consultant - Member Experience

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 performance on 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 Work In this role, you will:Actively engage leadership and staff at all levels within a provider group/medical practice setting to enhance the member experienceInfluence the development and implementation of programs that improve member experienceDevelop resourcing strategies to ensure optimum support for projects and for the day-to-day operational activities. Develop and deliver training programs within provider groups to increase awareness of behaviors and techniques that affect member experienceReview program budget variance and scope change requests, and participate in the budget-resolution process  Lead cross-functional meetings and foster teamwork; drive escalation and resolution of issues, while promoting collaboration and coordination across broad categories of stakeholders   Support and coach project managers within the program, while providing technical expertise in planning, execution, and leadership of program, projects, and initiatives  Identify best practices for achieving high performance on Consumer Assessment of Healthcare Providers and systems (CAHPS) and Health Outcomes Survey (HOS) measures, meeting provider groups/medical clinics where they are in their member experience journey; Collaborate with providers to create actionable strategies and process improvement plans targeting specific performance metricsUtilize and integrate CAHPS, HOS, and other predictive analytic data to assist organizations in improving performance and lead special projects and activities focused on CAHPS and HOS performance improvementMaintain awareness of industry regulations that impact CAHPS/HOS survey measures and incorporate them into strategic initiativesAnalyze and interpret survey data to identify trends, solve complex challenges, and develop strategic plans in collaboration with provider groups to drive process improvementsYour Knowledge and Experience Requires a bachelor's degree or equivalent experienceRequires at least 7 years of prior relevant experienceRequires 3+ years of experience in healthcare quality improvement, provider engagement, or Medicare Advantage performance initiativesRequires familiarity with CMS regulations and Medicare Advantage programsRequires a proven track record of leading successful provider engagement and member experience initiativesRequires experience in facilitating peer-to-peer learning opportunities among providers to drive innovation and continuous improvementRequires expertise in analyzing and applying survey data (CAHPS, HOS, NPS) to drive performance improvement

Created: 2025-05-01