Arkansas Blue Cross and Blue Shield logo
Arkansas Blue Cross and Blue Shield

We live here, work here and raise our families here – we are dedicated to Arkansas and to you.

Manager, Clinical Program Management – Vendor Performance

Program ManagerProgram ManagerFull TimeRemoteLeadTeam 1,001-5,000Since 1948H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

8 days ago

Salary

0

Seniority

Lead

Bachelor Degree7 yrs expEnglish

Job Description

Manager, Clinical Program Management – Vendor Performance

Arkansas Blue Cross and Blue Shield

• Compiles reporting related to the performance and continuous improvement of Utilization Management (UM), Care Management (CM) and vendor programs. • Collaborates across clinical, operational and analytic teams for all lines of business to ensure compliant and high quality member centered outcomes. • Supports program monitoring, reporting, vendor performance management, and execution of internal operational improvements and vendor oversight for compliance requirements.

Job Requirements

  • Bachelor’s degree in healthcare administration, public health, social work or related field required.
  • Master’s degree in nursing preferred.
  • Clinical licensure such as Registered Nurse (RN), Licensed Practice Nurse (LPN), and/or Social Work (SW) preferred.
  • Knowledge of Utilization Review Accreditation Commission (URAC) Utilization Management/Care Management standards preferred.
  • Minimum seven (7) years' experience Utilization Management or Care Management OR applicable master’s with minimum five (5) years’ experience.
  • Minimum two (2) years’ leadership experience (team, role, and/or project management).
  • Minimum of two (2) years demonstrated experience in reporting or dashboarding for program management to track key performance indicators.
  • Experience managing or working with external vendors preferred.
  • Strong knowledge of Utilization Management or Care Management workflows, documentation standards, and care coordination processes.

Benefits

  • Tuition reimbursement.
  • Club Blue, a free, onsite gym to encourage exercise.
  • Green Leaf Grill and Green Leaf Grill Express, onsite restaurants in Little Rock that promote healthy eating.
  • Incentives for wellness education and exercise

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