Clinical Program Manager
New
M
Martin's Point Health CareHealthcare Administration
United StatesFull-TimeManager
Salary114,957.4 - 142,006.2 USD per year
Apply NowOpens the employer's application page
Job Details
- Experience
- 10 years’ experience in healthcare
- Required Skills
- Data AnalysisMicrosoft Excel
Requirements
- Bachelor’s Degree in Health Science, Nursing or related field required.
- 10 years’ experience in healthcare including managed care.
- Focus in Program Management, overseeing clinical programs and driving process improvement initiatives.
- Experience using data and data analysis to design and monitor programs and manage ROI.
- Experience in evaluating financial and clinical performance metrics.
- Demonstrated experience with NCQA case management accreditation standards, audit preparations, and HEDIS quality metrics.
- Proficiency in Microsoft Excel, Visio, Word, PowerPoint, Outlook, and Access.
- Demonstrated track record of driving new clinical programs through implementation and monitoring.
- Demonstrated expertise managing teams and multi-disciplinary workgroups without direct authority.
- Master's degree (MBA, MHA, or MPH) preferred.
- Certified Case Manager (CCM) or ACMA certification preferred.
- Experience in Medicare Advantage and TRICARE preferred.
Responsibilities
- Support program development activities, including operational reporting and program resources.
- Translate organizational strategy into actionable, localized case management work plans.
- Streamline case management workflows to eliminate clinical inefficiencies and improve member engagement.
- Optimize data reporting structures to track program metrics and identify trends for clinical interventions.
- Monitor program benchmarks and key performance indicators to measure CM Program success.
- Ensure all clinical initiatives comply with TriCare, CMS, NCQA, and other regulatory standards.
- Identify trends, gaps, and operational risks through performance monitoring.
- Develop presentations, communication, and program tools to support CM Program.
- Partner with cross-functional leaders to implement new clinical initiatives.
- Collaborate with IT and analytics teams to refine software platforms and reporting dashboards.
View Full Description & ApplyYou'll be redirected to the employer's site
