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    Program Manager Clinical, Principal - Long Beach, United States - Hispanic Technology Executive Council

    Hispanic Technology Executive Council
    Hispanic Technology Executive Council Long Beach, United States

    1 week ago

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    Description
    Your Role

    The Program Manager Clinical, Principal in collaboration with the Regional Medical Director and internal Blue Shield of California teams will be responsible for collaborating with all 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 work:

    In this role, you will:
    Operate at a strategic business level to ensure projects/programs are in line with Blue Shield of Californias strategic goals
    Consult with all levels (including senior management) making recommendations and influencing 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

    Perform data analysis for all lines of business: Analyze data in collaboration with Regional Medical Director for trends, drivers, and key initiatives.

    Incorporate the analysis into meaningful discussions with Group/IPA
    Identify opportunities around utilization, quality, and clinical initiatives: Work side by side with internal and external partners in the design and launch of clinical programs focused on high-risk members, hospital initiatives, and behavioral health as well as internal innovation programs
    Partner with medical groups to co-create programs encompassing a full spectrum of initiatives around disease management, complex care management, transitions of care and site of service; ensuring optimal utilization, access, and quality of care for members
    Lead with a collaborative approach and an understanding of existing resources and relationships between/among partner organizations while moving them towards constructive change
    Work cross functionally with Blue Shield of California internal teams to provide support both ad hoc and for recurrent initiatives
    Your Knowledge and Experience
    Requires a current, active California RN, NP, or PA license
    Requires a bachelors degree; advanced degree is preferred
    Requires a minimum of 10 years of prior relevant experience
    Experience in case utilization, quality improvement and disease management
    In-depth understanding of the managed care delegated model and associated efficiency and quality measures. Health plan experience is preferred
    Excellent verbal and written communication style to drive positive outcomes
    Strong data analytic skills and advanced knowledge in Microsoft 365, especially in Excel applications
    Ability to be resourceful and collaborative; a team collaborator with strong listening skills and the ability to offer creative solutions to drive consensus

    Pay Range:
    The pay range for this role is: $136,400.00 to $204,600.00 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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