What are the responsibilities and job description for the Program Manager Clinical, Principal position at Blue Shield of CA?
Your Role
The Clinical Program Manager, Principal in collaboration with the Regional Medical Director and the CMO Team for Commercial Business will be responsible for collaborating with all internal stakeholders and externally facing partners to transform the way health care is delivered, ensuring best-in-class care for all members. Priority is given to delivering on the Quadruple Aim (lower cost care, increased quality, increased member satisfaction and physician satisfaction) with a focus on execution to drive and accelerate improvements in primary care for all patients. This role will report to the Regional Medical Director.
Your Knowledge and Experience
- Requires a current, active California RN, NP, or PA license
- Requires a bachelor's degree; advanced degree is preferred
- Requires a minimum of 10 years of prior relevant clinical or job related experience
- Requires previous health plan experience with understanding of Accountable Care Organizations (ACO), global versus shared risk financial arrangements, quality metrics and member experience. Experience in case utilization and utilization management and managed care delegated models is a plus.
- In-depth understanding of data analytics with mastery of excel and an ability to use multiple data platforms for internal and external communication.
- Strong PowerPoint application skills to create executive summaries and presentation decks.
- Excellent verbal and written communication style to drive positive outcomes
- Ability to be resourceful and collaborative; a team collaborator with strong listening skills and the ability to offer creative solutions to drive consensus.
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.
