Clinical Programs Manager

3 weeks ago

Los Angeles, California, United States Blue Shield of California Full time

Your Role

The Medical Care Programs team at Blue Shield of California is responsible for overseeing programs that support members with their healthcare needs, while driving cost savings and improving quality. As a Clinical Program Manager, Consultant, you will report to the Senior Manager, Medical Care Programs and lead a cross-functional taskforce focused on a specific employer client.

Your Responsibilities

  • Provide overall program leadership, guidance, and management of all aspects of a given program, including requirements gathering, business case creation, and implementation.
  • Lead steady leadership in the face of uncertainty, change, and aggressive deadlines common to a rapidly growing company with an evolving business model.
  • Review program budget variance and scope change requests, and participate in the budget-resolution process.
  • 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 programs, projects, and initiatives.
  • Foster a culture of innovation and continuous improvement, identifying and driving improvements and actions to significantly impact the cost of healthcare.
  • Maintain detailed documentation of taskforce activities and action items, as well as interventions, outcomes, and impacts.
  • Partner closely with analytics teams to develop, analyze, and distribute reporting.

Your Requirements

  • Requires a bachelor's degree or equivalent experience.
  • Requires at least 7 years of prior relevant experience.
  • Requires current California LVN, RN, NP, or PA license.
  • Prefers familiarity with health care data and the health care delivery system in California; health plan or provider experience strongly desired.
  • Prefers Utilization Management experience; Care/Case Management experience also desired.
  • Strong organizational and/or project management skills, consistent ability to "self-start" and take ownership of end-to-end taskforce activities.
  • Excellent written and oral communication skills, ability to facilitate cross-functional discussions, lead teams through influence to drive actions and outcomes.

Pay Range

The pay range for this role is: $ to $ for California.

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