Program Manager Clinical, Principal

Your Role

The Blue Shield Behavioral Health Clinical Market Engagement, Strategy and Programs team works with internal and external business and clinical partners to develop, execute, and evaluate Blue Shield of CA’s strategy and ecosystem for behavioral health and addiction medicine.” This Principal Program Manager, Clinical role will report to the Director of Behavioral Health Clinical Market Engagement, Strategy and Programs. In this role you will work with cross-functional internal partners support Blue Shield’s behavioral health quality and integrated medical/behavioral health initiatives across all lines of business. The role will own a portfolio of work and lead projects with internal partners for continuous quality improvement activities e.g. meeting requirements for NCQA, regulatory/mandate programming, member/provider experience improvement.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Work

In this role, you will:

Operate at a strategic business level to ensure projects/programs are in line with Blue Shield of California strategic 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.

Plan and implement multiple and extremely complex projects/programs spanning across business areas and quality improvement/management initiatives relative to mental healthcare and substance abuse services.

Determine key clinical and business issues, develop effective action plans and implement to successful conclusion.

Design, execute, evaluate sustained high-performance portfolio of products across a prevention & clinical spectrum.

Represent Blue Shield Behavioral Health at relevant quality and strategy workgroups, forums, and in committees.

Manage regular internal stakeholder communications through project & product management tools that identify progress, risks, etc.

Your Knowledge and Experience

Bachelor’s degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree and completion of an accredited educational program that meets the requirements for the applicable professional license is required

Requires an unrestricted CA license RN, PA, LCSW, LMFT, LPCC, or PsyD

Requires at least 10 years of prior relevant experience including service quality programs and/or service products, health plan operations, or equivalent.

Requires experience with behavioral healthcare from any combination of perspectives: vendor, payer/plan, MBHO, clinical, provider relations, products, program evaluation, IPA or medical group, hospital, etc.

Requires experience driving sustainable change across multiple stakeholders focused on continuous quality improvement initiatives & strategies

Vendor and/or product development and management experience including proposal development, selection, evaluation, marketing and communications is preferred.

Experience with integrated behavioral/medical health care models and practice considerations is preferred.

Hybrid This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.