Program Manager Clinical, Senior- Medi-Cal

Blue Shield of CA; San Diego (CA); Hybrid; USD 90,000 - 150,000; Full time

Job summary

Blue Shield of California is seeking a Senior Program Manager, Clinical to lead administrative and operational support for Social Programs, ensuring compliance and contract adherence while delivering member-centered services.

This hybrid role requires collaboration with provider groups, Medi-Cal experience, and strong analytical, communication, and vendor management skills to drive results. You will report to the Senior Manager, Social Programs Management.

Qualifications

• 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.

Responsibilities

• Provide administrative and operational organization, compliance oversight, updates, and contract adherence.
• Support the Social Programs team in alignment with member-centered services in communities.
• Collaborate with providers, communities, and agencies to coordinate services.

Skills

Administrative skills

Analytical skills

Communication skills

Multitasking

Project management

Vendor management

Provider collaboration

Education

Bachelor's degree

High School Diploma/GED with 4 years relevant experience in lieu of degree

Tools

Excel

Microsoft Word

Microsoft Outlook

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.