Cambia Health Solutions

Assistant Director, Clinical Services

Cambia Health Solutions

full-time

Posted on:

Location Type: Hybrid

Location: Lewiston • Idaho • Oregon • United States

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Salary

💰 $136,000 - $184,000 per year

Job Level

Lead

About the role

  • Accountable for the performance and results of teams focused on delivering care management programs and services that support members mental and physical wellbeing and health.
  • Supports implementation of an industry leading health strategies that are integrated with utilization management, pharmacy, and provider network teams.
  • Works closely with cross-functional leaders to clarify goals and priorities and create operational plans to ensure successful execution of initiatives.
  • Prepares and presents program summaries, and outcomes to various committees, levels of stakeholders and executive leadership.
  • Represents program goals and initiatives with various audiences, internal and external.
  • Supports evaluation and recommendations regarding use of vendors to support health strategies.
  • Provides clinical expertise and leadership to improve the quality and cost of care delivered to members through provider partnerships.
  • Collaborates with Medical Directors, Health Informatics, Provider Services and other departments as needed to collect, analyze, and report on health utilization trends and effectiveness of programs, quality and outcomes.
  • Aligns health program strategy and goals with organization's vision and strategy.
  • Champions and creates a sense of urgency within the organization related to evolving health programs.

Requirements

  • Bachelor's degree in nursing or comparable clinical degree including master's degree in psychology, sociology, social work or related field
  • 7 years clinical experience
  • 5 years of management experience in health insurance or managed care related field.
  • Experience in health plan case management, utilization management or quality management or equivalent combination of education and experience preferred
  • Active unrestricted professional license in nursing, psychology, psychiatry, social work or related clinical field
  • Experience in areas such as integrated care management models, partnerships with providers, third-party suppliers of clinical services, community groups and other member-facing stakeholders
  • Ability to lead the design, development and implementation of clinical programs, processes, structure, and measurement indicators that drive operational results.
  • Experience executing and driving complex projects that require collaboration in a matrixed environment.
  • Demonstrated competency in using data to drive decisions, organizing work, providing leadership, establishing measures for success, and managing to deliverables.
  • Proven ability to build relationships, collaborating with diverse business partners and stakeholders who may or may not have direct accountability or engagement.
  • Strong communication and facilitation skills with all levels of the organization, including the ability to resolve issues and build consensus among groups of diverse stakeholders
  • Demonstrated ability to deliver results in compliance with all local, state, and federal regulatory requirements, including HEDIS.
  • NCQA or URAC Accreditation experience strongly preferred.
  • Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired.
Benefits
  • Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
  • Annual employer contribution to a health savings account.
  • Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
  • Market-leading retirement plan including a company match on employee 401(k) contributions, with a potential discretionary contribution based on company performance (no vesting period).
  • Up to 12 weeks of paid parental time off (eligibility requires 12 months of continuous service with Cambia immediately preceding leave).
  • Award-winning wellness programs that reward you for participation.
  • Employee Assistance Fund for those in need.
  • Commute and parking benefits.
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
clinical experiencemanagement experiencehealth plan case managementutilization managementquality managementdesign and development of clinical programsdata-driven decision makingproject executionoperational results measurementintegrated care management models
Soft Skills
leadershipcollaborationcommunicationfacilitationrelationship buildingproblem resolutionconsensus buildingorganizational skillsability to drive resultssense of urgency
Certifications
active unrestricted professional license in nursingactive unrestricted professional license in psychologyactive unrestricted professional license in psychiatryactive unrestricted professional license in social workNCQA AccreditationURAC Accreditation