Program Manager, Principal - Medicare PPO

Program Manager, Principal - Medicare PPO Blue Shield of CA United States, California, Lodi Apr 23, 2026 Your Role The Program Manager, Principal provides leadership and operational support to advance quality performance across clinical programs and contracted provider groups. This role drives the implementation, oversight, and continuous improvement of quality structures, processes, and outcomes necessary to achieve high performance in Medicare Stars, HEDIS, risk adjustment, preventive care, and valuebased care programs for a PPO product line. This position partners closely with internal teams, including Clinical Quality, Medicare Stars, Product, IT, Finance, Population Health, Clinical Integration, and Medicare Operations-as well as external provider groups to ensure successful execution of quality initiatives and organizational goals. 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 equivalent combination of education and experience. 10 years of increasingly responsible experience in healthcare quality, population health, or clinical operations. Demonstrated experience in project/program management. Experience with quality performance measures such as HEDIS, Medicare Stars, patient experience measures, and risk adjustment models in the PPO space or Fee for Service (FFS) space. Ability to interpret and use quantitative and quantitative data to drive improvement. Knowledge of quality improvement practices and methodologies. Lean, Six Sigma, or Performance Improvement training or certification. Intermediate to advanced proficiency with Microsoft Excel, PowerPoint, and other analytical/project management tools. 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.