What are the responsibilities and job description for the Program Manager Clinical, Principal position at Blue Shield of California?
Your Role
To be considered for an interview, please make sure your application is full in line with the job specs as found below.
The Special Populations Unit (SPU) ensures effective oversight and monitoring of vulnerable groups identified by CalAIM, advancing equitable access to care and improving health outcomes. Through cross-functional collaboration and data-driven strategies, we advocate for inclusive, person-centered solutions that promote the well-being of those we serve.
The Program Manager Clinical, Principal will report to the Director of Special Populations Unit, Office of the Chief Medical Officer. Your role will focus on establishing strong collaboration and partnership with Utilization Management, Population Health Management (inclusive of Care Management, Transitional Care Services and Social Services), Behavioral Health and other clinical teams and assisting in the development of an oversight framework.
Your Work
In this role, you will :
- Establish SPU program goals and performance metrics to ensure effectiveness and alignment with organizational objectives
- Act as a clinical subject matter expert, providing guidance to stakeholders on program design and implementation
- Facilitate cross-departmental collaboration to drive alignment and integration of services
- Collect, analyze, and interpret clinical and operational data to assess program performance and impact
- Identify trends, develop improvement plans, and implement evidence-based interventions.
- Help develop a compliance framework to ensure Special Populations programs comply with federal, state, and local healthcare regulations, as well as accreditation standards.
- Monitor policy changes affecting special populations and adapt programs as necessary.
- Contribute to strategic planning efforts to ensure programs align with long-term organizational goals.
- Consult with all levels including senior management, make recommendations, and influence decision-making
- Leverage cross-functional internal and external relationships to drive initiatives forward
- Determine key business issues, develop effective action plans and implement to successful conclusion
- Lead with a collaborative approach and an understanding of existing resources and relationships between / among partner organizations while moving them towards constructive change
Your Knowledge and Experience
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