Clinical Project Lead - Hybrid

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:

• Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week
• Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week
• Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month
• Onsite: daily onsite requirement based on the essential functions of the job
• Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building

Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week.

This position is hybrid within the state of AZ only.

The Clinical Project Lead is responsible for leading established clinical initiatives, including the development, implementation, and evaluation of clinical practice guidelines, member education materials, and provider resources in collaboration with the Director of Care Management. This role works collaboratively across departments to promote evidence-based care, member engagement, and health equity. This role also supports efforts to improve access and outcomes for justice-involved individuals, helping bridge gaps in care during transitions and reentry.

• 3 years of experience in nursing, public health, clinical research, healthcare project management, or guideline development
• 2 years of experience in care coordination

• Bachelor’s degree or higher in a relevant field such as nursing, public health, pharmacy, life sciences (biology or chemistry), a behavioral health field of study, or healthcare administration

• N/A

• N/A

• 5 years of experience in nursing, clinical research, healthcare project management, or guideline development

• N/A

• Active, current, and unrestricted license to practice in the State of Arizona (a state in the United States) as a Registered Nurse (RN) or independent license in the behavioral health profession such as LCSW, LPC, LISAC LMFT

• Project Management Professional (PMP), Six Sigma/Lean Project Management, Certified Care Manager (CCM), or related certification

• Identify and maintain current evidence-based clinical practice guidelines for the Medicaid segment, in collaboration with internal and external stakeholders
• Develop and update member education materials and self-management tools, ensuring that the selected materials meet the needs of the member population
• Evaluate and implement certified decision-making aids for the provider network
• Ensure materials are…