Hybrid Program Manager - Clinical & Healthcare Cost Analytics

Blue Shield of CA; Redding (CA); Hybrid; USD 110,000 - 160,000; Full time

Job summary

Blue Shield of California seeks a Program Manager Clinical, Consultant to analyze clinical and financial data, identify trends, and lead projects that improve care while reducing costs for employer-funded plans. You will develop clear presentations and communicate insights to stakeholders in a hybrid work setting.

The role requires 7+ years of experience and California licensure. This leadership-focused team emphasizes growth, critical thinking, and results, with opportunities to influence cost

Qualifications

• Requires a Bachelor's degree or HS diploma with 4 years of relevant experience.
• Requires at least 7 years of prior relevant experience.
• California LVN, RN, NP, or PA license is required.
• Healthcare data and CA delivery familiarity preferred.
• Strong organizational and project management skills.
• Excellent written and oral communication; ability to lead cross-functional discussions.
• Experience with cost of health care analysis and population health outcomes.
• Power BI or similar data visualization tools experience.
• Experience with employer fully insured and self-insured populations is desired.

Responsibilities

• Analyze clinical and financial data to identify trends and opportunities to improve care and manage costs.
• Lead projects addressing opportunities and develop clear action plans.
• Develop presentations communicating clinical insights and recommended actions.
• Facilitate meetings with internal and external stakeholders to drive results.
• Drive healthcare cost trend improvements through direct interventions and system-level initiatives.

Skills

Project management

Communication skills

Data analysis

Data visualization

Stakeholder facilitation

Cost-of-care analysis

Root-cause analysis

Cost containment

Cross-functional collaboration

Healthcare claims review

Provider reimbursement knowledge

Education

Bachelor's degree

California RN/LVN/NP/PA license

Tools

Power BI

Job description

Blue Shield of California seeks a Program Manager Clinical, Consultant to analyze clinical and financial data, identify trends, and lead projects that improve care while reducing costs for employer-funded plans. You will develop clear presentations and communicate insights to stakeholders in a hybrid work setting.

The role requires 7+ years of experience and California licensure. This leadership-focused team emphasizes growth, critical thinking, and results, with opportunities to influence cost