Job Description

Your Role

The Behavioral Health Operations Oversight team plays a key role by driving the execution and monitoring of regulatory mandates and compliance initiatives. This position ensures organizational readiness, accuracy, and sustainability of behavioral health operations in alignment with state, federal, contractual and accreditation requirements. The Program Manager, Principal will report to the Sr. Manager, Mandates and Implementations. In this role you will collaborate across departments to design and implement process improvements, manage risk, and support long-term compliance strategies.

Your Work

In this role, you will:


Operate at a strategic business level to ensures projects/programs are in line with Blue Shield of California strategic goals Consult with all levels including senior management, make recommendations, and influence decision-making Leverage cross-functional internal and external relationships to drive initiatives forward Plan and implement multiple and extremely complex projects/programs spanning across business areas Determine key business issues, develop effective action plans and implement to successful conclusion Consult with team members in development of behavioral health regulatory compliance training programs and materials to support adherence of mandates Drive continuous improvement initiatives to strengthen compliance infrastructure and operational excellence Operate the execution, tracking, and sustainability of behavioral health mandates and regulatory requirements. Lead the implementations of regulation and legislation that impact behavioral health compliance initiatives, ensuring timeliness and accuracy Manage and monitor risk reporting processes to identify, mitigate, and escalate operational risks

Your Knowledge and Experience

Requires a bachelor's degree or equivalent experience Requires at least 10 years of prior relevant experience Minimum of 10 years of healthcare compliance experience Minimum of 5 years of relevant experience in healthcare/behavioral health operations within a managed care environment Strong expertise in regulatory implementation, compliance oversight, operational risk management Demonstrated analytical expertise, encompassing the capacity to interpret complex laws, regulations, and related documents, as well as assessing their implications Exceptional written and verbal communication skills, with experience preparing executive-level reports



ABOUT THE TEAM

About Blue Shield of California

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.


At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. 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 achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.


Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. 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 listen and communicate effectively, showing empathy by understanding others' perspectives.

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:

At Blue Shield of California and the Ascendiun Family of Companies, we believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility. As we continue to evolve our workplace model, our focus remains on creating spaces where our people can connect with purpose - whether working in the office or through a hybrid approach - by providing clear expectations while respecting the diverse needs of our workforce.


Two Ways of Working:

Hybrid (Default):

Work from a business unit-approved office at least two (2) times per month (for roles below Director-level) or once per week (for Director-level roles and above). Exceptions:
o Member-facing and approved out-of-state roles remain remote.


o Employees living more than 50 miles from their assigned offices are expected to work with their managers on a plan for periodic office visits.


o For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

On-Site:

Work from a business unit-approved office an average of four (4) or more days a week.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

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.