Licensed Clinical Educator, Consultant - Behavioral Health Case Management

Job title: Licensed Clinical Educator, Consultant - Behavioral Health Case Management in Oakland, CA at Blue Shield of California
Company: Blue Shield of California
Job description: Job Category: Healthcare Services and OperationsJob Description:Your RoleThe Enterprise Learning team is responsible for all new hire and existing staff technical and clinical education for multiple departments within Medical Care Solutions. This includes Utilization Management, Case Management, Population Health Management, Post Service, and Appeals & Grievances. The Licensed Clinical Educator, Consultant will report to the Senior Stakeholder Manager in Enterprise Learning. In this role you will be supporting the clinical education programs for new and existing staff supporting Behavioral Health Case Management and partner cross-functionally with the Behavioral Health Care Management department to develop clinical training modules for Behavioral Health trainingResponsibilities:Your WorkIn this role, you will:

• Manage and facilitate formal clinical education for new hires and existing clinical staff for Behavioral Health Care Management
• Clinical education on Behavioral Health Care Management for all lines of business (Medicare, Medi-Cal, Commercial, etc.)
• Develop and design training modules for Behavioral Health clinical education for Case Management and Social Services teams
• Clinical new hire and continuing education on Behavioral Health Care Management department processes and workflows
• Create learning competencies and assessments for Behavioral Health Care Management education program
• Support Behavioral Health projects for Blue Shield of California
• Partner will quality team and compliance to address quality trends or compliance issues that require training or continuing education
• Support education on regulatory mandates for Behavioral Health
• Use the ADDIE model to support Behavioral Health projects
• Use Kirkpatrick model to evaluate Behavioral Health learning effectiveness

Qualifications:

• Requires a Bachelor's degree or equivalent experience
• Requires a current and unrestricted California RN or LCSW
• Requires a minimum 7 years of prior relevant Case Management experience
• Requires experience working in a Behavioral Health clinical setting
• Requires experience working for a Health Payer in Care Management
• Knowledge of DMHC, NCQA, CMA, and DHCS regulatory agencies, preferred
• Experience educating and training clinicians, preferred
• Experience developing clinical training programs, preferred

About the Team:About Blue Shield of CaliforniaAs of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities - join us!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 listen and communicate effectively, showing empathy by understanding others' perspectives.
• Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

Our Workplace Model:At Blue Shield of California and the Ascendiun Family of Companies, we believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility. As we continue to evolve our workplace model, our focus remains on creating spaces where our people can connect with purpose - whether working in the office or through a hybrid approach - by providing clear expectations while respecting the diverse needs of our workforce.Two Ways of Working:

• Hybrid (Default): Work from a business unit-approved office at least two (2) times per month (for roles below Director-level) or once per week (for Director-level roles and above). Exceptions:

o Member-facing and approved out-of-state roles remain remote.o Employees living more than 50 miles from their assigned offices are expected to work with their managers on a plan for periodic office visits.o For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

• On-Site: Work from a business unit-approved office an average of four (4) or more days a week.

Physical Requirements:Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.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.
Expected salary:
Location: Oakland, CA
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