Clinical Account Manager, Consultant - Commercial

Your Role

The Commercial CMO team works across multiple teams within Blue Shield to ensure smooth implementations for the commercial lines of business. The Program Manager Clinical Consultant, will report to the Regional Medical Director. In this role you will be responsible for working on premier accounts as part of the Commercial CMO team.

Oversees clinical program management responsibilities for various commercial lines of business with a focus on premier accounts, working closely with medical management functional area teams, account management, medical directors, sales, and clients. This role will work cross functionally with sales, account management, vendors, medical directors, utilization management, and care management and mandates teams.

Leverage clinical knowledge to liaison between internal and external stakeholders for our care management models. Support high profile client interactions using clinical knowledge to advise and resolve client escalations. Responsible for managing projects and business process improvement activities to ensure ongoing alignment with Blue Shield of CA s strategy and company objectives, as well as interdependencies of other business units.

• Requires a bachelor s degree or equivalent experience
• Requires at least 7 years of prior relevant experience
• Valid CA license in a clinical discipline such as RN, LVN, NP, PA, MSW, CPhT
• Exceptional communication and presentation skills
• Ability to synthesize clinical data into a concise story
• Ability to think outside of the box and quickly problem solve
• Excellent analytical skills