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Senior Clinical Program Manager

Blue Shield of CA - San Diego, CA

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Job Description

Your Role As a Senior Clinical Program Manager, you will play a pivotal role in enhancing healthcare delivery in collaboration with the Regional Medical Director and the Chief Medical Officer Team for Commercial Business. This dynamic position allows you to work alongside internal stakeholders and external partners to drive innovation and ensure exceptional care for all members. Your primary focus will be on achieving the Quadruple Aim: reducing care costs, enhancing quality, and improving both member and physician satisfaction. You will report directly to the Regional Medical Director. Your Knowledge and Experience Active RN, NP, or PA license in California is essential. Bachelor's degree is a must; an advanced degree is highly preferred. A minimum of 10 years of relevant clinical experience is required. Experience with health plans and a solid understanding of Accountable Care Organizations (ACO), global versus shared risk financial models, quality metrics, and member experience is crucial. Familiarity with case utilization and managed care delegated models would be an advantage. Proficient in data analytics with mastery of Excel and ability to navigate various data platforms for effective communication is required. Strong skills in PowerPoint to create engaging executive summaries and presentation decks. Excellent verbal and written communication skills are critical for fostering positive outcomes. You should be resourceful, collaborative, and possess strong listening skills with the ability to propose creative solutions to achieve consensus.

Created: 2026-03-10

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