Program Manager II

This is a fully remote position, open to applicants in Missouri.

📋 Description

• Strategically plan, organize, monitor, and oversee programs utilizing cross-functional teams to fulfill defined requirements and achieve business needs and strategic goals.

• Support initiatives within the business department that promote quality, safety, and cost-of-care improvements.

• Collect requirements and develop plans and schedules.

• Manage resources effectively and facilitate the execution and deployment of projects.

• Employ corporate and industry-standard tools and methodologies to oversee programs in accordance with departmental procedures.

• Maintain comprehensive business process documentation, which includes meeting minutes, action items, issue logs, and risk management strategies.

• Develop and track department deliverables to ensure compliance with quality standards, including clinical reporting documents, reference materials, and policy and procedure documentation.

• Communicate program progress to management and key stakeholders.

• Identify resources, address issues, and mitigate risks.

• Identify requirements, procedures, and challenges to enhance existing processes.

• Facilitate cross-functional meetings to align with stakeholder expectations and business objectives.

• Manage projects throughout the entire project life cycle.

• Provide leadership and communicate project updates to stakeholders.

• Negotiate with project stakeholders to secure resources, resolve issues, and address risks.

• For DE only: Coordinate teams to ensure the accuracy and reporting of HEDIS data, including investigations, audits, and improvement opportunities.

• For DE only: Collaborate with both internal and external stakeholders on HEDIS and CAHPS initiatives.

• For Virginia Total Care only: Supervise the delivery of Consumer Directed services and collaborate with partners and health plans to implement system-wide solutions and quality services.

• For New Hampshire Healthy Families only: Identify, secure, and manage transportation for members; oversee the NEMT subcontractor; propose operational enhancements; resolve member and provider complaints; assist with real-time service rescheduling.

• Perform additional duties as assigned.

• Adhere to all policies and standards.

⛳️ Requirements

• Bachelor's Degree in a related field or equivalent experience is required.

• A minimum of 3 years of experience in quality improvement, program management, or project management is required.

• Experience in healthcare is preferred.

• For DE only: 3 years of experience in Quality Improvement, HEDIS Program Management, or healthcare-related experience.

• For DE only: Proficient knowledge of NCQA and HEDIS programs.

• For Carolina Complete Health: At least 2 years of experience working with Medicaid beneficiaries.

• For Carolina Complete Health: Minimum of 2 years of project management experience coordinating large, complex engagements.

• For Carolina Complete Health: At least 2 years of experience coordinating diverse stakeholders.

• For Carolina Complete Health: Minimum of 2 years in a field or organization demonstrating an understanding of how social needs impact individuals’ health and well-being.

• For Virginia Total Care: Minimum of 2 years of direct experience in Consumer Directed services or 3 years of experience with waiver programs, with a working knowledge of CD services.

• For Virginia Total Care: Managed Care experience is preferred.

• For New Hampshire Healthy Families: 4 years of experience in transportation.

• For Sunshine Health Quality Improvement: Bachelor’s degree in Public Health, Health Sciences, Healthcare Administration, or a related field, or equivalent experience.

• For Sunshine Health Quality Improvement: 3+ years of program management, project management, or healthcare experience.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase options.

• Tuition reimbursement opportunities.

• Paid time off plus holidays.

• Flexible work arrangements including remote, hybrid, field, or office schedules.

• Additional incentive programs may be included in total compensation.

• Equal opportunity employer committed to fostering diversity.