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Program Manager, Principal

Blue Shield of CA
United States, California, Lodi
Jan 22, 2025

Your Role

The Appeals and Grievances team helps our members with their concerns, ensures compliance and supports audit activity. The Program Manager, Principal will report to the Sr. Director of Grievances and Appeals. In this role you will support the systems and system changes leveraged by the Appeals and Grievances team, and ensure the system implementation, testing, changes and oversight (including vendor oversight) are managed effectively. You will also be responsible for supporting compliance, regulatory audit activity, inventory management, addressing drivers of inventory, and vendor oversight.

Your Knowledge and Experience




  • Requires a bachelor's degree or equivalent experience
  • Requires at least 10 years of prior relevant experience
  • Requires at least 5 years Appeals and Grievances experience
  • Requires experience in Appeals and Grievance system change, implementation and vendor oversight
  • Requires advanced experience in risk mitigation, problem solving and analysis as well as preparing and presenting related materials.



Pay Range:

The pay range for this role is: $ 136,400 to $ 204,600 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.

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