Program Manager Clinical, Principal
About The Position
The Principal Program Manager, Clinical works on Blue Shield of California’s Behavioral Health Clinical Market Engagement, Strategy and Programs team, which develops, executes, and evaluates the organization’s behavioral health and addiction medicine strategy and ecosystem with internal and external business and clinical partners. Reporting to the Director of Behavioral Health Clinical Market Engagement, Strategy and Programs, this role supports behavioral health quality and integrated medical/behavioral health initiatives across all lines of business. The role owns a portfolio of work and leads projects with internal partners for continuous quality improvement, including NCQA requirements, regulatory and mandate programming, and member and provider experience improvement. The position operates at a strategic business level, leading complex, cross-functional projects and programs related to mental healthcare and substance abuse services. It develops action plans for clinical and business issues, manages a portfolio of prevention and clinical products, represents Behavioral Health in quality and strategy forums, and communicates progress and risks to internal stakeholders. The role follows a hybrid workplace model, generally requiring two in-office days each week for most teams; employees more than 50 miles from an office location coordinate in-office time with their manager based on business need.
Requirements
- Bachelor’s degree, or a high school diploma/GED plus four years of additional relevant experience in lieu of a degree, and completion of an accredited educational program that meets requirements for the applicable professional license.
- Unrestricted California license as an RN, PA, LCSW, LMFT, LPCC, or PsyD.
- At least 10 years of prior relevant experience, including service quality programs and/or service products, health plan operations, or equivalent.
- Experience with behavioral healthcare from one or more perspectives, such as vendor, payer/plan, MBHO, clinical, provider relations, products, program evaluation, IPA or medical group, or hospital.
- Experience driving sustainable change across multiple stakeholders focused on continuous quality improvement initiatives and strategies.
Nice To Haves
- Vendor and/or product development and management experience, including proposal development, selection, evaluation, marketing, and communications.
- Experience with integrated behavioral/medical healthcare models and practice considerations.
Responsibilities
- Ensure projects and programs align with Blue Shield of California’s strategic goals.
- Consult with all levels, including senior management; make recommendations and influence decision-making.
- Use cross-functional internal and external relationships to advance initiatives.
- Plan and implement multiple, extremely complex projects and programs spanning business areas and quality improvement or management initiatives related to mental healthcare and substance abuse services.
- Identify key clinical and business issues, develop effective action plans, and implement them through successful conclusion.
- Design, execute, and evaluate a sustained high-performance portfolio of products across the prevention and clinical spectrum.
- Represent Blue Shield Behavioral Health in relevant quality and strategy workgroups, forums, and committees.
- Manage regular internal stakeholder communications using project and product management tools to identify progress, risks, and related information.
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What This Job Offers
Job Type
Full-time
Career Level
Principal
