Assistant Director Clinical Services
Hybrid within Oregon, Washington, Idaho or Utah
Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.
Who We Are Looking For:
Every day, Cambia's dedicated team of clinical leaders are living our mission to make health care easier and lives better. As a member of the Clinical Services team, our Assistant Director Clinical Services provides leadership and clinical direction for clinical care management, clinical programs, and provider engagement strategies across all health plan lines of business. This role oversees core medical and/or behavioral health teams, condition specific programs, and engages in the development of new programs and services. In addition, this role supports implementation of enterprise-wide health strategy initiatives and may represent clinical service programs to external parties and customers as needed. This role works collaboratively with the utilization management team, medical directors and the broader health service leadership team to effectively manage health care costs while achieving quality outcomes. Consultation with Product, Network Management, Quality, Finance and
Sales ensures the clinical offerings are market competitive and designed to support the care needs of our members - all in service of creating a person-focused health care experience.
As a people leader, you are willing to learn and grow, understanding that leadership is a craft that is continuously honed as you support your team and the lives that depend upon us.
What if your next leadership role combined clinical excellence with strategic innovation? Ready to lead clinical innovation that truly makes health care easier and lives better? Then this role may be the perfect fit.
What You Bring to Cambia:
Qualifications:
* 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
Skills and Attributes:
* 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
What You Will Do at Cambia:
* Accoun
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