Registered Nurse, Senior

Blue Shield of California's mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that truly serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our comprehensive approach to DE&I combines a focus on our people processes and systems with a deep commitment to promoting social justice and health equity through our products, business practices, and presence as a corporate citizen.

Blue Shield has received awards and recognition for being a certified Great Place to Work, best place to work for LGBTQ equality, leading disability employer, one of the best companies for women to advance, Bay Area's top companies in volunteering & giving, and one of the world's most ethical companies. Here at Blue Shield of California, we are striving to make a positive change across our industry and the communities we live in - join us!

Your Role

The Blue Shield Promise Health Plan clinics team provides seamless primary and urgent care services to the Promise Health Plan members. The Registered Nurse- Clinical Program Manager will report to the Senior Clinic Manager. In this role you will be responsible for strategic oversight, alignment, and integration for clinical programs that support Blue Shield Promise Health Plan clinic members. You will assist to define clinical projects required to support HEDIS initiatives and other preventative healthcare services.

Your Work

In this role, you will:

• Deliver patient care through assessment, planning, implementation, and evaluation of patient needs that meets the standard, mission and values of Blue Shield Promise Health Plan

• Research and create treatment/care plans to promote quality of care

• Design appropriate and fiscally responsible plan of care with targeted interventions that enhance quality, access and cost-effective outcomes

• Supports team through consistent and successful workload management to achieve team goals, regulatory timelines, and accreditation standards

• Works closely with clinic leadership and providers to ensure members are active participants in their healthcare treatment plans

• Participates in the planning of healthcare events, screenings, and promotions, manages programs from initiation/pilot phase through delivery/spread and monitor for continuous improvement.

• Provides input, plans or organizes member outreach for healthcare events, ensures that resources are utilized appropriately

• Manages reporting for HEDIS data, quality measures and healthcare initiatives, identifies gaps in members healthcare measures, preventative, and annual care

• Provides clinical support to healthcare providers within their scope of practice, including but not limited to triage, wound care services for members, and medication administration

Your Knowledge and Experience

• Requires at least 5 years of prior experience in a Primary Care setting

• Bilingual is desired but not required

• Wound care experience is desired, but not required

Our Values

• Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.

• Human. We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes.

• Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

Additional Information

• Equal Employment Opportunity:

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.

COVID Vaccine Policy

From the earliest days of the pandemic, Blue Shield of California has been unyielding in our commitment to putting the health and safety of our people, our members and our communities first. As a federal contractor and a health care company, Blue Shield requires all employees to be up to date with COVID-19 vaccination prior to start date as a condition of employment. Blue Shield will consider requests for medical or religious accommodation to this vaccination requirement prior to your start date.

• If the role youre applying for is deemed an Essential Role, the Company has already determined that essential functions of the role can only be performed in Blue Shield of California offices or in the field. To protect the health and safety of our employees, business partners, and members, employees in Essential Roles must be up-to-date on COVID vaccination.

The definition of up to date with your COVID-19 vaccine is when you have received all doses in the primary series and one booster when eligible. ?If you are unable to be up to date with your COVID-19 vaccine by your start date, your start date will need to be postponed and you will have 30 days to remedy. If you cannot fulfill the requirement nor obtain an accommodation within 30 days, your offer will be rescinded.

• Requisition ID: 220022P
• Posting Date: May 26, 2022
• Schedule: Full-time