Program Manager - Payer Operations (Alma)

Spring Health; United States; On-site; USD 90,000 - 130,000; Full time

Job summary

Alma is seeking a Program Manager for Payer Operations to own end-to-end RCM processes and partner across Operations and Business Development. You will coordinate credentialing, rostering, claims adjudication, and CX to ensure nothing falls through the cracks and to drive improvements in payer performance.

You will lead cross-functional collaboration, monitor payer performance, and translate operational insights into actions that improve outcomes for Alma providers and their clients.

Qualifications

• Experience navigating end-to-end payer operations and RCM processes.
• Ability to coordinate multiple stakeholders without direct authority.
• Track record of delivering cross-functional projects on schedule.

Responsibilities

• Track payer issues end-to-end with clear ownership and accountability.
• Improve RCM efficiency and revenue performance through initiatives.
• Coordinate with internal teams to surface interdependencies and resolve issues.
• Serve as primary operations contact for BD counterparts on payer requirements.
• Support payer calls with insights to drive RCM discussions and alignment.
• Monitor for new payer requirements and mergers; mobilize teams to implement.
• Track and report RCM performance by payer and highlight risks.

Skills

Healthcare operations

Cross-functional collaboration

Highly organized

Ambiguity tolerance

Clear communicator

Data-driven

Job description

Program Manager - Payer Operations (Alma)

Alma, a Spring Health company, is looking for a Program Manager to join our Payer Success team within Operations. In this role, you'll be the central quarterback for our payer partnerships in steady-state operations – the person who holds the full picture across the end-to-end RCM lifecycle, from credentialing and rostering to claims adjudication to CX. You won't be expected to solve every issue yourself, but you will be the one making sure nothing falls through the cracks: tracking open issues, mobilizing the right internal experts, and driving accountability across teams until problems are resolved. You'll work closely across all teams at Alma, in particular within Operations and Business Development, to turn operational insights into action and improve outcomes across our payer portfolio.

What you'll do

• Track open payer issues end-to-end, ensuring clear ownership, visibility, and accountability across cross-functional teams until resolution
• Drive measurable business outcomes by improving RCM efficiency and effectiveness, with the ultimate goal of increasing revenue performance and delivering a better experience for Alma providers and their clients
• Partner closely with internal operations teams to connect the dots across stakeholders, subteams, and workflows - surfacing interdependencies and ensuring issues move to resolution rather than stall
• Serve as the primary operational point of contact for BD counterparts, triaging and coordinating new requirements surfaced by the payer and claims, roster, complaints, and escalation issues across assigned payers
• Partner with the Business Development Team on payer calls to drive RCM discussions, align stakeholders, and move issues to resolution
• Proactively monitor for new payer requirements and evolving payer mergers, and mobilize the right internal teams to implement changes before they become problems
• Track and report on RCM performance by payer - surfacing trends, flagging risks, and ensuring the right teams are engaged to drive improvement

What success looks like:

• On-time completion of payer initiatives/projects
• Completion and maintenance of payer health assessments/business reviews
• Stakeholder satisfaction (internal and payer partners)

Who you are

• Experienced in healthcare operations - you understand how insurance claims and payer relationships actually work
• A strong cross-functional collaborator who can align people across teams without direct authority
• Highly organized with a track record of managing complex, multi-stakeholder projects from kickoff through launch
• Comfortable in ambiguity - you can proactively identify what needs to happen next without waiting to be told
• A clear communicator who can distill operational complexity for both internal partners and external payer contacts
• Detail-oriented and data-driven, with the ability to monitor performance metrics and translate them into action