Program Manager Clinical, Senior- Medi-Cal

Blue Shield of CA; Los Angeles (CA); Hybrid; USD 90,000 - 120,000; Full time

Job summary

Blue Shield of California is seeking a Senior Program Manager, Clinical to lead the Social Programs team, ensuring eligible members receive appropriate services in a member-centered way within our care communities. This role emphasizes administrative and operational coordination, compliance oversight, updates, and contract adherence, reporting to the Senior Manager, Social Programs.

A licensed clinician with Medi-Cal and managed care experience is preferred; strong analytical and communication

Qualifications

• Bachelor's degree or HS diploma with 4 years of relevant experience
• 5+ years of relevant experience
• Licensed clinician (LCSW, LMFT, LPCC, PsyD or similar)
• 2+ years with Medi-Cal
• Experience with Managed Care Plan preferred
• Experience collaborating with provider groups and community resources
• Program, project and vendor management experience
• Strong Excel, Word, Outlook and multitasking abilities
• Strong analytical, problem solving, and communication skills

Responsibilities

• Administrative and operational organization, compliance oversight, updates, and contract adherence
• Support leadership development and team effectiveness
• Collaborate with providers, community resources, and agencies
• Ensure member-centered services align with benefits and community needs

Skills

Administrative skills

Microsoft Excel

Microsoft Word

Microsoft Outlook

Multitasking

Communication skills

Analytical skills

Problem solving

Education

Bachelor's degree or equivalent

Licensure: LCSW/LMFT/LPCC/PsyD or similar

Job description

Your Role

The Social Programs team is responsible for the support, oversight and administration of Social Programs benefits and services ensuring that our eligible members receive appropriate services in-line with benefits and services that is member-centered and in the communities where our members seek care. The Program Manager Clinical, Senior will report to the Senior Manager, Social Programs Management of direct manager. In this role you will primarily provide administrative and operational organization, compliance oversight, updates, and contract adherence.

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

• Requires a bachelor's degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree
• Requires at least 5 years of prior relevant experience
• Requires LCSW, LMFT, LPCC, PsyD or similar by the Board of Behavioral Sciences
• Requires at least 2 years prior relevant experience working with Medi-Cal
• Preferred at least 1-year prior relevant experience working with a Managed Care Plan
• Requires experience collaborating with provider groups, community resources, and agencies
• Requires program, project, and vendor/provider management experience
• Requires strong administrative skills including proficiency in Excel, Microsoft Word, and Microsoft Outlook and the ability to multitask and track multiple projects/deliverables at one time
• Requires strong analytical, problem solving, and communication skills

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.