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Manager, Clinical Program Management – Vendor Performance
Arkansas Blue Cross and Blue ShieldManager of Clinical Program Management and Vendor Performance overseeing Utilization and Care Management programs at Arkansas Blue Cross. Collaborating and reporting for improved member outcomes in a healthcare setting.
About the role
Key responsibilities & impact- 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.
Requirements
What you’ll need- 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
Comp & perks- 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
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
reportingprogram monitoringvendor performance managementoperational improvementsUtilization ManagementCare Managementdashboardingkey performance indicatorscare coordination processesdocumentation standards
Soft Skills
collaborationleadershipteam managementproject managementcommunication
Certifications
Bachelor’s degreeMaster’s degreeRegistered Nurse (RN)Licensed Practice Nurse (LPN)Social Work (SW)