Program Manager Clinical, Consultant (Case Notes)

Your Role

The Commercial CMO Team provides clinical oversight for programs and processes that support members' health care, reduce costs, and improve quality. The Program Manager Clinical, Consultant reports to the Director of Program Management, Clinical - CMO.

In this role, you will analyze clinical and financial data to identify trends and opportunities to improve care and manage costs for employer-funded health insurance. Leading projects to address these opportunities and develop presentations that clearly communicate the clinical insights and recommended actions. You will also facilitate meetings with internal and external stakeholders and drive improvements in healthcare cost trends through both direct interventions and broader, system-level initiatives.

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 equivalent experience
• Requires at least 7 years of prior relevant experience
• Requires current California LVN, RN, NP, or PA license
• Prefers familiarity with health care data and the health care delivery system in California; health plan or provider experience strongly desired
• Strong organizational and/or project management skills, consistent ability to "self-start" and take ownership of end-to-end taskforce activities
• Excellent written and oral communication skills, ability to facilitate cross-functional discussions, lead teams through influence to drive actions and outcomes
• Experience in cost of health care analysis, population health outcomes, and/or program evaluation desired

Hybrid Virtual Work
This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.