Clinical Program Manager, II, Sr. DOE

Cambia Health Solutions • Lewiston, ID

7d • Hybrid

About The Position

This is a hybrid role requiring 3 days/week in office, with potential work locations in Burlington, Renton, Spokane, Vancouver, Portland, Medford, Salt Lake City, Boise, Lewiston, or Fargo. Candidates must reside within commutable distance of a listed location or be willing to relocate. The Clinical Program Manager provides direction, oversight, and organization to ensure the overall success of one or more complex clinical programs (e.g., cost stewardship, specialty pharmacy, care management, etc.). This role supports a Health Service Organization (HSO) executive or directing program sponsor to ensure program deliverables are met while striving to improve care quality, enhance consumer experience, and reduce cost. Responsibilities include managing program initiatives from inception to sustainment and providing oversight related to program evaluation, development, processes, and reporting during all phases of the program. Initiatives may involve managing internally developed programs or programs established through a vendor partnership. This role requires strong communication skills and the ability to build relationships across the organization (e.g., Health Care Services, Health Plan Operations, Data & Technology, and Finance) to make members’ health journeys easier.

Requirements

• Bachelor's Degree in Business, Health Care Administration, or related field (Masters preferred)
• Minimum 5+ years' experience with project and/or program management in healthcare, healthcare insurance operations or other large, complex industry
• Experience in clinical area preferred.
• Ability to think analytically, effectively applying project management and financial techniques, and providing recommendations to management using critical thinking and sound judgment.
• Ability to coordinate cross-functionally with all levels of the organization for the purpose of driving solutions and resolving issues in a timely and effective manner.
• Proficiency in effectively managing high-profile projects, identifying and mitigating risks, and reporting barriers to program deliverables.
• Strong analytical skills, with the ability to analyze complex data and situations, learn quickly and create options, recommendations and action plans.
• Experience in independently defining, developing, managing and reporting on processes and metrics.
• Ability to accomplish results through others by establishing relationships, effective controls and monitoring processes.
• Ability to partner effectively with external partners/vendors.
• Familiarity with health plan and clinical terminology, operations and trends.
• Excellent communication and facilitation skills with all levels of the organization, including the ability to resolve complex issues, build consensus among groups of diverse stakeholders, manage strategic partner relationships, and effectively lead and engage internal teams in the fulfillment of roles and responsibilities.
• Solid knowledge of program evaluation concepts and methodologies, with experience in program effectiveness analysis, measurement, and reporting.

Nice To Haves

• Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired.

Responsibilities

• Provides direction, oversight and organization to ensure overall success of one or more complex clinical programs.
• Supports a HSO executive or directing program sponsor to ensure program deliverables are met while striving to improve care quality, enhance consumer experience, and reduce cost.
• Manages program initiatives from inception to sustainment.
• Provides oversight related to program evaluation, development, processes and reporting during all phases of the program.
• Manages program and project teams to identify risks and opportunities across multiple initiatives or workstreams.
• Maintains systems for ongoing data and statistical reporting.
• Develops and communicates program documents and project plans.
• Collaborates with internal program leaders, senior management, and cross-functional managers to develop monitoring and assessment protocols for evaluation and improvement.
• Uses data, market intelligence, and deep business analysis to identify opportunities, develop business cases, surface actionable insights, design new solutions or programs, and recommend program and process changes aligned with corporate and division goals.
• Uses a thorough understanding of the business and specialized clinical knowledge to provide objective assessments of existing programs, influence initiatives, drive innovative solutions, and support clinical strategy development as assigned.
• May independently lead and develop clinical strategies in partnership with Medical Directors and other key leaders, including leading the planning and execution of annual corporate objectives work.

Benefits

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
• Annual employer contribution to a health savings account.
• Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
• Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
• Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
• Award-winning wellness programs that reward you for participation.
• Employee Assistance Fund for those in need.
• Commute and parking benefits.
• Competitive base pay
• Market-leading 401(k) with a significant company match
• Bonus opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level