Clinical Program Manager

Company: Cambia Health
Location: Seattle
Posted on: June 25, 2022

Job Description:

Clinical Program Manager

Remote within ID, OR, WA, or UT. Candidates outside of these states will not be considered.

Primary Job Purpose

The UMP Clinical Program Manager will lead and manage all of the clinical programs and relationships with the HCA clinical staff. Serve as the clinical expert accountable for ensuring all clinical programs and initiatives are executed meeting our contractual and regulatory obligations. Participate in all meetings that impact UMP clinical programs both at HCA and at Regence. Build strong relationships with HCA clinical team.

General Functions and Outcomes

* Serve as the primary point of contact for HCA/UMP Clinical Staff and Regence medical management team for all HCA/UMP clinical programs and issues.


* Ensure all clinical deliverables and requirements in the UMP contract are met.


* Serve as the lead for the HTA work both internally and at HCA, performing any HTA related meetings and work per the contract.


* Serve as the lead for the ABA program managing entire program both with HCA/UMP and within Regence.


* Serve as the lead for the IOCP, DCP, Bariatric Surgery, and ACO work between Regence and HCA/UMP.


* Serve as the clinical lead, managing the Clinical Strategies meetings and related work.


* Coordinate all HCA/UMP reporting between Health Informatics, the ASO team, and Regence support staff.


* Resolve all HCA/UMP clinical issues that are escalated within Regence or by HCA/UMP.


* Ensure all standard reports, daily and monthly activity reports, points of contact, calendar of events, meetings, agendas, and minutes are maintained and completed.


* Attend daily, weekly, monthly, quarterly and annual meetings with HCA/UMP clinical staff, both in person and via phone.


* An active participant on the ASO Medical Management team


* Work directly with the operations and reporting analyst assigned to support all of the clinical work for UMP.



Minimum Requirements

* Comprehensive knowledge of the health care industry and related benefit products and services.


* Ability to work well independently with autonomy and effective prioritization.


* Demonstrated team player, able to organize teams to come together around a goal and deliver.


* Ability to work in a matrix organization having direct reports but also able collaborate with people who are above and below


* Strong computer skills with demonstrated ability to use MS Office products and other software and reporting tools.


* Excellent verbal and written communication skills, to include presentation skills.


* Demonstrated analytical ability to identify problems, develop solutions and implement a chosen course of action.


* Ability to organize, plan, prioritize and develop multiple projects within time constraints.


* Ability to negotiate and resolve complex and sensitive project and team issues with diplomacy and persuasiveness.



Normally to be proficient in the competencies listed above

UMP Clinical Program Manager would have a Bachelor's degree in Nursing or related field, 3 years of experience in a clinical and/or operational environment and 5 years account management or customer management experience or equivalent combination of education and experience.

Required Licenses, Certifications, Registration, Etc.

Current RN or LPN license to practice in Washington State

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 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 for 100 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 Privacy Policy.

This position includes 401(k), healthcare, paid time off, paid holidays, and more. For more information, please visit www.cambiahealth.com/careers/total-rewards.

We are an Equal Opportunity and Affirmative Action 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 background check is required.

If you need accommodation for any part of the application process because of a medical condition or disability, please email CambiaCareers@cambiahealth.com. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy. As a health care company, we are committed to the health of our communities and employees during the COVID-19 pandemic. Please review the policy on our Careers site.

Keywords: Cambia Health, Seattle , Clinical Program Manager, Executive , Seattle, Washington