Program Manager, Healthcare Services

Provides subject matter expertise and leadership to healthcare services function, providing support for project/program/process design, execution, evaluation and support, and ensuring compliance with regulatory and internal standards, practices, policies and contractual commitments. Contributes to overarching strategy to provide quality and cost-effective member care.

Requirements

• At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of the following areas: utilization management, care management, care transitions, behavioral health, or equivalent combination of relevant education and experience.
• Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC) or Licensed Marriage and Family Therapist (LMFT). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates.
• Strong analytical and problem-solving skills, Strong organizational and time-management skills, Ability to work in a cross-functional, professional environment, Experience working within applicable state, federal, and third-party regulations, Strong verbal and written communication skills, Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.

Benefits

• Competitive benefits and compensation package