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Cambia Health Solutions Program Manager, Clinical Programs Development and Performance in Seattle, Washington


Program Manager, Clinical Programs Development and Performance

Seattle, WA; Portland, OR; Boise, ID; Salt Lake City, UT; Lewiston, ID, Burlington, WA,; Tacoma, WA; Telecommute within WA, OR, ID, UT.

Working collaboratively with the Clinical Services Leadership Team, lead the clinical workstreams to design, launch and implement new clinical programs including internal and purchased programs. Includes clinical program design and development, external market scans for emerging clinical program trends, evaluation of build vs. buy business cases, assessment of vendor solutions, support of go-to-market processes and RFP proposals. Provides cross-functional leadership to bring new clinical programs to market with hand offs to Clinical Services operational leaders for on-going management and sustainment of new clinical programs. Works collaboratively with Clinical Services leaders and vendor management team, Cambia Health internal partners including Sales, Marketing, Product, Strategic Finance and Sourcing; and external partners and vendors. Contributes to the Clinical Services strategic roadmap and priorities, strategic initiatives, annual operating plan and clinical scorecard. Provides clinical vendor case management oversight and works collaboratively with vendor management team to evaluate effectiveness of clinical vendor partnerships on overall population health

At Cambia, our values are fundamental to achieving our Cause of transforming the health care industry. They guide our actions and bring diverse perspectives together to improve the health care journey better for those we serve. All eight values are equally important and linked to the others: Empathy, Hope, Courage, Trust, Commitment, Collaboration, Innovation, and Accountability. These values are not just words on paper - we live them every day.

Responsibilities & Requirements

General Functions and Outcomes

  • In partnership with clinical leaders, assesses market trends and evaluates need for new program offerings.

  • Facilitates development of strategic initiatives, roadmaps, scorecards and RFPs for Clinical Services.

  • Effectively leads tactical execution of large scale, complex clinical transformation programs

  • Establishes and maintains program management practices and process, actively supporting Clinical Services goals and objectives.

  • Provides day-to-day leadership of cross-functional project teams comprised of business, technology and vendor/consulting resources.

  • Creates a sense of urgency within the organization and translates quickly evolving directions into action.

  • Trains the organization on all program related changes as necessary and drives communication strategy across functional teams and the organization

  • Works closely with cross-functional leaders to clarify program goals and create operational plans to ensure successful execution of the relationship with our provider partners. ?

  • Works collaboratively with teams to plan, design, develop, implement, and manage programs to ensure ongoing performance expectations for the program are met.

  • Represents program goals and initiatives with various audiences. Cultivates and maintains relationships with key internal and external stakeholders.

  • Develops and oversees monitoring and reporting procedures to ensure deliverables and budget are on track. Communicates program status and areas of risk or opportunity.

  • Partners with cross-functional leaders, provider groups, and vendors to lead organizational change.

Competencies and Knowledge:

  • Expertise in health plan clinical programs with a focus on population health and care coordination.

  • Experience in areas such as care management models, partnerships with providers, third-party suppliers of clinical services, community groups and other member-touching stakeholders.

  • Proven ability to lead the design, development and implementation of process, structure, tools and measurement indicators that drive operational results.

  • Demonstrated experience leading a large scale, complex business transformation and/or system implementation in a multi-state environment.

  • Experience in clinical vendor case management.

  • Experience in new product/service development, especially in healthcare and/or with a significant information technology compliment; demonstrated success in leading product/service development teams.

  • Demonstrated ability to work collaborative and cross-functionally and organize cross functional activities to deliver results in a matrixed organizational structure.

  • Excellent judgment, problem solving, creativity, flexibility, analytical, communication and presentation skills.

  • Experience with business process redesign and optimization including ability to recognize process deficiencies and recommend and implement improvements.

  • Excellent written and verbal communication skills, ability to present and facilitate and drive executive level discussions and strong customer and stakeholder management skills.

Normally to be proficient in the competencies listed above:

  • Program Manager, Clinical Programs and Performance, would have a Bachelor’s degree in nursing or behavioral health or Master’s degree in healthcare administration, public health or related field, 8 years of experience in project and/or program management preferably in Clinical Case Management, and/or Population Health, including management/leadership experience or equivalent combination of education and experience.

Required Licenses, Certifications, Registration, Etc.

  • Professional license in nursing, psychology or related clinical field preferred.

About Us

Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. We offer a competitive salary and a generous benefits package. We are an equal opportunity employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A drug screen and background check is required.

Regence is 2.2 million members, here for our families, co-workers and neighbors, helping each other be and stay healthy and provide support in time of need. We've been here for members more than 90 years. Regence is a nonprofit health care company offering individual and group medical, dental, vision and life insurance, Medicare and other government programs as well as pharmacy benefit management. We are the largest health insurer in the Northwest/Intermountain Region, serving members as Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (in Washington). Each plan is an independent licensee of the Blue Cross and Blue Shield Association.If you’re seeking a career that affects change in the health care system, consider joining our team at Cambia Health Solutions. We advocate for transforming the health care system by making health care more affordable and accessible, increasing consumers’ engagement in their health care decisions, and offering a diverse range of products and services that promote the health and well-being of our members. Cambia's portfolio of companies spans health care information technology and software development; retail health care; health insurance plans that carry the Blue Cross and Blue Shield brands; pharmacy benefit management; life, disability, dental, vision and other lines of protection; alternative solutions to health care access and free-standing health and wellness solutions.

Information about how Cambia Heath Solutions collects, uses, and discloses information is available in our .

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Job LocationsUS-WA-Seattle | US-OR-Portland | US-ID-Boise | US-UT-Salt Lake City | US-WA-Burlington | US-WA-Tacoma | US-ID-Lewiston | US-Telecommute

Requisition ID2020-27061

Category (Portal Searching)Health Care Services