Program Manager, Healthcare Services

Job summary

This role provides deep subject-matter knowledge and leadership for the healthcare services team. The position supports the design, delivery, review, and improvement of projects, programs, and processes while helping ensure adherence to internal policies, regulatory requirements, and contractual obligations. The work contributes to the broader effort to deliver high-quality care in a cost-effective way for members.

What you'll do

• Plan and drive internal healthcare services initiatives with department or cross-functional experts, guiding work from early design through final delivery.
• Keep stakeholders informed about program objectives, results, and support needs, and help maintain consistent protocols and operating procedures.
• May coordinate and monitor the work of outside vendors when needed.
• Support process optimization, change management, and program execution aligned with business priorities.
• Act as a content expert and lead healthcare services efforts that address important organizational needs.
• Work with customers and partners to translate goals and needs into clear functional requirements.
• Perform quality reviews to identify training needs and service-quality gaps, and help implement improvement initiatives.
• Prepare business requirements documents, test plans, requirements traceability matrices, user guides, and related documentation.

Required qualifications

• Minimum 5 years of healthcare experience, including clinical operations, plus at least 3 years in one or more of the following: utilization management, care management, care transitions, behavioral health, or a comparable mix of education and experience.
• Valid professional credential such as RN, LVN, LPN, APSW, CHES, LPC, LPCC, or LMFT, when required by state contract, regulation, operating model, or licensing rules; any license held must be active and unrestricted in the state of practice.
• Well-developed analytical and problem-solving ability.
• Strong planning, prioritization, and time-management skills.
• Comfort working across teams in a professional, collaborative environment.
• Experience operating within state, federal, and third-party regulatory requirements.
• Strong spoken and written communication skills.
• Proficiency with Microsoft Office and other relevant software, along with the ability to use online portals and databases.

Preferred qualifications

• Additional credentials such as CCM, CPHM, CPHQ, or other healthcare or management certifications.
• Prior leadership experience.
• Experience serving Medicaid or Medicare populations.

Compensation and benefits

The organization offers a competitive compensation and benefits package. The posted annual pay range for this role is $65,791.66 to $142,548.59, with actual pay depending on location, experience, education, and skill level.

Additional information

Current employees who want to be considered for this opening should apply through the internal job board. The employer is an equal opportunity employer (EOE) M/F/D/V.