Program Manager Clinical, Principal

Blue Shield of CA; Lodi (CA); Hybrid; USD 150,000 - 190,000; Full time

Job summary

Blue Shield of CA is seeking a Principal Program Manager, Clinical to lead behavioral health strategy and programs. You will own a portfolio and drive projects with internal partners to improve quality and meet regulatory requirements.

The role emphasizes collaboration across teams, with focus on continuous learning and leadership development under a hybrid workplace model.

Qualifications

• Bachelor's degree or High School Diploma/GED with 4 years of additional relevant experience.
• Unrestricted CA license RN, PA, LCSW, LMFT, LPCC, or PsyD requested.
• 10+ years of prior relevant experience including service quality programs or health plan operations.

Responsibilities

• Develop and evaluate the behavioral health strategy and programs.
• Lead cross-functional projects for quality improvement and regulatory initiatives.
• Coordinate with internal and external partners to meet NCQA and mandate requirements.

Skills

Project management

Cross-functional collaboration

Quality improvement

Education

Bachelor's degree

High School Diploma/GED

Job description

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 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 isrequired
• 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.