Senior Clinical Programs Lead, Behavioral Health Strategy

Blue Shield of CA; Rancho Cordova (CA); Hybrid; USD 150,000 - 210,000; Full time

Job summary

Blue Shield of CA is seeking a Principal Program Manager, Clinical to lead behavioral health strategy and programs. You will partner with clinical and business teams to drive quality improvement, NCQA readiness, and regulated programming across all lines of business.

You will manage a portfolio of initiatives, influence vendor relations, and advance integrated behavioral/medical health care models in a hybrid office setting in California.

Qualifications

• 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 multiple perspectives (vendor, payer, MBHO, clinical, etc.).
• Requires experience driving sustainable change across multiple stakeholders for continuous quality improvement initiatives & strategies.
• Vendor and/or product development and management experience is preferred.
• Experience with integrated behavioral/medical health care models is preferred.

Responsibilities

• Lead projects with internal partners for continuous quality improvement activities and NCQA/regulatory programming.
• Own a portfolio of work and drive cross-functional initiatives across lines of business.
• Collaborate with vendors, providers, and payers to support behavioral health quality outcomes.
• Influence strategy and programs that integrate behavioral and medical health care.

Skills

Healthcare industry knowledge

Quality improvement

Cross-functional leadership

Regulatory/compliance

Vendor management

Strategy development

Education

CA professional license requirement

Bachelor's degree or HS diploma + 4 years experience

Job description

Blue Shield of CA is seeking a Principal Program Manager, Clinical to lead behavioral health strategy and programs. You will partner with clinical and business teams to drive quality improvement, NCQA readiness, and regulated programming across all lines of business.

You will manage a portfolio of initiatives, influence vendor relations, and advance integrated behavioral/medical health care models in a hybrid office setting in California.