Clinical Consultant Jobs in California
Clinical Consultant jobs in California are among the most active in the country, with strong demand concentrated in healthcare systems, life sciences, medical device companies, and managed care organizations and openings that range from entry-level associate consultant roles through senior and principal-level positions. The largest hiring metros are Los Angeles, San Francisco, and San Diego, where employers such as Kaiser Permanente, Sutter Health, and Johnson and Johnson maintain major California operations and regularly bring on clinical consultants across therapeutic areas. The most in-demand specialties include clinical informatics, utilization management, and specialty pharmacy consulting. Find a role that fits below and apply directly.
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Showing 5 of 42+ Clinical Consultant jobs
Your Role
The Commercial CMO Team provides clinical oversight for programs and processes that support members’ health care, reduce costs, and improve quality. The Program Manager Clinical, Consultant (Line of Business) reports to the Director of Program Management, Clinical – CMO. In this role, you will analyze clinical and financial data to identify trends and opportunities to improve care and manage costs for employer-funded health insurance, lead projects to address these opportunities and develop presentations that clearly communicate the clinical insights and recommended actions. You will also facilitate meetings with internal and external stakeholders and drive improvements in healthcare cost trends through both direct interventions and broader, system-level initiatives.
Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.
Your Work
In this role, you will:
Provide analysis, leadership, and guidance, for a given line of business, including opportunity identification, business case creation, and implementation
Provide steady leadership in the face of uncertainty, change, and aggressive deadlines common to a rapidly growing company with an evolving business model
Create presentations and manage meeting requests at a high level.
Lead cross-functional meetings and foster teamwork; drive escalation and resolution of issues, while promoting collaboration and coordination across broad categories of stakeholders
Collaborate with analytics, actuarial, and quality teams to develop, analyze, and distribute reports, and document program activities, interventions, and outcomes
Perform deep-dive analysis of high-cost claims, vendor-identified populations, and other defined groups, producing case studies, reports and presentations
Research and recommend interventions; identify and drive improvements and actions to significantly impact the cost of healthcare.
Conduct detailed reviews of high-cost claims and episodes of care to identify actionable cost-saving opportunities, including site-of-care optimization, inappropriate utilization, claims payment integrity issues, contractual compliance, and coordination of benefits
Analyze inpatient admissions, readmissions, specialty drug utilization, and high-cost professional and facility claims to identify key drivers of healthcare trend and develop targeted mitigation strategies
Identify opportunities for site-of-service steerage, provider network optimization and out-of-network utilization management, care management interventions, and benefit design enhancements to reduce total cost of care
Monitor emerging healthcare cost drivers, including specialty pharmaceuticals, oncology, behavioral health, specialist and emergency department utilization, and recommend appropriate interventions
Measure and communicate intervention outcomes, including savings realized, quality impacts, operational effectiveness, and member experience considerations
Partner closely with analytics teams to develop, analyze and distribute reporting
Liaise with analytics and cost of healthcare groups across the enterprise to compare trends, share knowledge, and measure outcomes
Organize and lead cross-functional meetings, foster teamwork and collaborative problem-solving across diverse stakeholders
Facilitate cross-functional taskforces with specific cost of healthcare commitments
Other duties as assigned
Your Knowledge and Experience
Requires a Bachelor’s degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree and a completion of an accredited educational program that meets the requirements for applicable professional license
Requires at least 7 years of prior relevant experience
Requires current California LVN, RN, NP, or PA license
Prefers familiarity with health care data and the health care delivery system in California; health plan or provider experience strongly desired
Strong organizational and/or project management skills, consistent ability to “self-start” and take ownership of end-to-end taskforce activities
Excellent written and oral communication skills, ability to facilitate cross-functional discussions, lead teams through influence to drive actions and outcomes
Experience in cost of health care analysis, population health outcomes, and/or program evaluation desired
Expertise in analyzing high-cost claims, episodes of care, and healthcare cost drivers to identify opportunities for medical cost reduction desired
Ability to review complex claims for payment accuracy, contractual compliance, coordination of benefits, and potential payment integrity issues desired
Prefers knowledge of provider reimbursement methodologies, including DRG, case rate, per diem, percentage-of-charge, and letter-of-agreement arrangements
Experience identifying fraud, waste, abuse, upcoding, unbundling, inappropriate billing, and other claim-payment vulnerabilities desired
Experience performing root-cause analyses of trend drivers and developing business cases for cost-of-care interventions desired
Strong proficiency using data visualization and analytical tools such as Power BI and other reporting platforms to communicate findings and recommendations
Experience working with employer fully insured and self-insured populations, large group accounts, and multidisciplinary stakeholder groups
Hybrid Virtual Work
This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.
ABOUT THE TEAM
About Blue Shield of California
As 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
We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:
For most teams, this means coming into the office two days per week.
Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.
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.
The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.
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.
Your Role
The Commercial CMO Team provides clinical oversight for programs and processes that support members’ health care, reduce costs, and improve quality. The Program Manager Clinical, Consultant (Line of Business) reports to the Director of Program Management, Clinical – CMO. In this role, you will analyze clinical and financial data to identify trends and opportunities to improve care and manage costs for employer-funded health insurance, lead projects to address these opportunities and develop presentations that clearly communicate the clinical insights and recommended actions. You will also facilitate meetings with internal and external stakeholders and drive improvements in healthcare cost trends through both direct interventions and broader, system-level initiatives.
Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.
Your Work
In this role, you will:
Provide analysis, leadership, and guidance, for a given line of business, including opportunity identification, business case creation, and implementation
Provide steady leadership in the face of uncertainty, change, and aggressive deadlines common to a rapidly growing company with an evolving business model
Create presentations and manage meeting requests at a high level.
Lead cross-functional meetings and foster teamwork; drive escalation and resolution of issues, while promoting collaboration and coordination across broad categories of stakeholders
Collaborate with analytics, actuarial, and quality teams to develop, analyze, and distribute reports, and document program activities, interventions, and outcomes
Perform deep-dive analysis of high-cost claims, vendor-identified populations, and other defined groups, producing case studies, reports and presentations
Research and recommend interventions; identify and drive improvements and actions to significantly impact the cost of healthcare.
Conduct detailed reviews of high-cost claims and episodes of care to identify actionable cost-saving opportunities, including site-of-care optimization, inappropriate utilization, claims payment integrity issues, contractual compliance, and coordination of benefits
Analyze inpatient admissions, readmissions, specialty drug utilization, and high-cost professional and facility claims to identify key drivers of healthcare trend and develop targeted mitigation strategies
Identify opportunities for site-of-service steerage, provider network optimization and out-of-network utilization management, care management interventions, and benefit design enhancements to reduce total cost of care
Monitor emerging healthcare cost drivers, including specialty pharmaceuticals, oncology, behavioral health, specialist and emergency department utilization, and recommend appropriate interventions
Measure and communicate intervention outcomes, including savings realized, quality impacts, operational effectiveness, and member experience considerations
Partner closely with analytics teams to develop, analyze and distribute reporting
Liaise with analytics and cost of healthcare groups across the enterprise to compare trends, share knowledge, and measure outcomes
Organize and lead cross-functional meetings, foster teamwork and collaborative problem-solving across diverse stakeholders
Facilitate cross-functional taskforces with specific cost of healthcare commitments
Other duties as assigned
Your Knowledge and Experience
Requires a Bachelor’s degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree and a completion of an accredited educational program that meets the requirements for applicable professional license
Requires at least 7 years of prior relevant experience
Requires current California LVN, RN, NP, or PA license
Prefers familiarity with health care data and the health care delivery system in California; health plan or provider experience strongly desired
Strong organizational and/or project management skills, consistent ability to “self-start” and take ownership of end-to-end taskforce activities
Excellent written and oral communication skills, ability to facilitate cross-functional discussions, lead teams through influence to drive actions and outcomes
Experience in cost of health care analysis, population health outcomes, and/or program evaluation desired
Expertise in analyzing high-cost claims, episodes of care, and healthcare cost drivers to identify opportunities for medical cost reduction desired
Ability to review complex claims for payment accuracy, contractual compliance, coordination of benefits, and potential payment integrity issues desired
Prefers knowledge of provider reimbursement methodologies, including DRG, case rate, per diem, percentage-of-charge, and letter-of-agreement arrangements
Experience identifying fraud, waste, abuse, upcoding, unbundling, inappropriate billing, and other claim-payment vulnerabilities desired
Experience performing root-cause analyses of trend drivers and developing business cases for cost-of-care interventions desired
Strong proficiency using data visualization and analytical tools such as Power BI and other reporting platforms to communicate findings and recommendations
Experience working with employer fully insured and self-insured populations, large group accounts, and multidisciplinary stakeholder groups
Hybrid Virtual Work
This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.
ABOUT THE TEAM
About Blue Shield of California
As 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
We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:
For most teams, this means coming into the office two days per week.
Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.
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.
The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.
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.
See All 42 Clinical Consultant Jobs in California
Find roles in California that match your experience and apply in just a few clicks.
Find Clinical Consultant JobsClinical Consultant Jobs by City in California
Where California roles are concentrated, by current openings.
Clinical Consultant Job Market in California
A snapshot from current California openings, updated as new roles post.
Who's Hiring
- Sutter Health10
- Pacific Health10
- Kaiser Permanente6
- 360 Behavioral Health3
- US Military Treatment Facilities under DHA3U
Top Industries Hiring
- Healthcare & Medical Services
What California Employers Look For
The qualifications that appear most often in clinical consultant jobs across California.
- Active California-recognized clinical license such as RN issued by the California Board of Registered Nursing
- Bachelor's degree in nursing, pharmacy, or a related clinical or health sciences field
- Minimum two years of direct patient care or clinical operations experience in a California healthcare setting
- Demonstrated knowledge of clinical documentation, utilization review, or care management workflows
- Proficiency with electronic health record systems such as Epic or Cerner used by California health systems
- Strong written and verbal communication skills for presenting findings to clinical and non-clinical stakeholders
Clinical Consultant Jobs in California: Frequently Asked Questions
How do you become a clinical consultant in California?
Most clinical consultant roles in California require an active clinical license, with the most common being a Registered Nurse license issued by the California Board of Registered Nursing, though pharmacists licensed by the California State Board of Pharmacy also qualify for many positions. From there, employers typically look for a bachelor's degree in a health sciences field and hands-on clinical experience before moving into a consulting capacity.
Which companies hire clinical consultants in California?
Employers hiring clinical consultants in California right now include Sutter Health, Pacific Health, and Kaiser Permanente, based on current listings on Migrate Mate as of October 2026. California's concentration of large integrated health systems, managed care plans, and life sciences companies means hiring tends to be consistent across both direct-employment and contract roles year-round.
Which California cities have the most clinical consultant jobs?
Pleasanton, Salida, and Tulare have the highest concentration of clinical consultant openings in California. Los Angeles and San Francisco generate the most volume due to their large hospital networks, managed care headquarters, and biotech and medical device employers, while San Diego's strong life sciences and pharmaceutical presence consistently drives demand for consultants with clinical and product expertise.
Are there remote clinical consultant jobs in California?
Yes, and more than many clinical roles allow, since a meaningful portion of clinical consulting work involves chart review, utilization management, and advisory functions that don't require an on-site presence. About 67% of clinical consultant openings tied to California are remote or hybrid as of October 2026, reflecting how much of the role centers on analysis and recommendations rather than direct patient interaction. Functions like clinical education, population health consulting, and payer-side case management are the most commonly offered in remote formats.
How can I get hired as a clinical consultant in California with little or no experience?
The most realistic entry path is moving from a bedside or direct-care role into a clinical operations or care coordination position first, since large California health systems such as Kaiser Permanente and Dignity Health regularly hire new nurses and pharmacists into utilization review or case management roles that build the analytical foundation consultants need. Completing your California clinical license early, gaining exposure to Epic or Cerner, and pursuing a certification such as the Accredited Case Manager credential strengthens a candidate's profile considerably before making the move into consulting.
Where can I find and apply to clinical consultant jobs in California?
You can find and apply to clinical consultant jobs in California on Migrate Mate, which lists current California openings from employers across the state. Search the listings to find roles that match your clinical background and experience level, then apply directly to the ones that fit.
See All 42 Clinical Consultant Jobs in California
Find roles in California that match your experience and apply in just a few clicks.
Find Clinical Consultant Jobs