Clinical Program Manager

WellCare of Kentucky; Indiana (PA); Hybrid; USD 87,700 - 157,800; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work schedules

Job summary

A national healthcare organization is seeking a clinical professional to manage clinical projects within its Medical Management team. The ideal candidate will have significant experience in healthcare management, particularly in quality improvement and utilization management. Responsibilities include overseeing project initiatives, collaborating with medical directors, and analyzing data. This role offers a competitive salary range of $87,700 to $157,800, along with comprehensive benefits and flexible work options.

Qualifications

• 5-7 years in managed care or medical group focusing on quality improvement and clinical operations.
• Experience in project management in a medical group, IPA, or health plan.
• Competence in analyzing data to drive outcomes.

Responsibilities

• Manage and track clinical projects supporting strategic plans.
• Work with the Regional Medical Director on key interventions.
• Lead cross-functional initiatives to drive performance improvement.
• Facilitate clinical report development and data delivery.

Skills

Project management

Data analysis

Quality improvement

Utilization management

Education

Bachelor’s Degree in Nursing OR equivalent

Master’s Degrees (MPH, MHA, MBA)

Tools

Microsoft

PowerBi

Google SmartSheets

Job description

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Project Management Experience

Technology Heavy Microsoft, PowerBi, Google SmartSheets, Lean Belt Helpful Knowledge of Medicaid Case management knowledge

Responsibilities

• Responsible for managing and tracking clinical projects that advance the objectives of strategic plan with key provider groups and/or hospital systems by supporting established committees and creating new work teams; including such activities as organizing and publishing agendas, documenting minutes, maintaining work plans and monitoring open action items
• Works closely with the Regional Medical Director to analyze data and develop and implement key interventions to support the Triple Aim, including developing work plans, workflows, policies and procedures, and serving as workgroup leader when appropriate in order to execute initiatives.
• Serves as project leader for cross functional initiatives that are intended to drive performance improvement engaging across functional teams as needed to ensure effective communication of project requirements, as well as tracks progress of action plans.
• Facilitates the development of clinical reports and the delivery of data to key provider partners; as well as develops internal reports to demonstrate progress.
• Performs detailed analysis of data, workflows, policies, procedures and organization of staff, in order to execute initiatives.
• May use project management software to support initiatives.
• Performs other duties as assigned
• Complies with all policies and standards

Qualifications

Education/Experience: Bachelor’s Degree in Nursing, International Medical Graduate, Master’s Degree in Public Health (MPH), Hospital Administration (MHA) or Business Administration (MBA) or equivalent experience. Five to seven years managed care, hospital or medical group experience, focusing on quality improvement, utilization management, or clinical operations. Experience analyzing and presenting data to drive outcomes. Experience making presentations in group settings. At least two years project management experience of managing a project at any level at a medical group, IPA or health plan setting.

Compensation

Pay Range $87,700.00 - $157,800.00 per year

Benefits

Centene offers a comprehensive benefits package including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.

Equal Opportunity

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.