Senior Program Manager, Payer Operations (Alma)

Springhealth; United States; Remote; USD 120,000 - 180,000; Full time

Job summary

Alma is seeking a Senior Program Manager to join the Payer Success team in Operations. You will own the end-to-end RCM lifecycle for payer partnerships, coordinating credentialing, rostering, claims adjudication, and CX to prevent issues from slipping through the cracks.

This fully remote role focuses on tracking open payer issues, driving cross-functional accountability, and delivering measurable improvements in RCM efficiency and revenue performance for Alma providers and their clients.

Qualifications

• Experience coordinating cross-functional teams and driving operational outcomes.
• Strong project management and stakeholder communication skills.
• Ability to track complex processes across multiple payer ecosystems.

Responsibilities

• Track payer issues end-to-end with clear ownership and accountability until resolution.
• Drive measurable outcomes by improving RCM efficiency and revenue performance, enhancing provider experience.
• Collaborate with operations to connect stakeholders, surface interdependencies, push issues to resolution.
• Act as primary operations contact for BD; triage and coordinate payer requirements surfaced by payer and claims•roster•escalation issues.
• Collaborate with BD on payer calls to drive RCM discussions and align stakeholders.
• Monitor payer requirements and mergers; mobilize teams to implement changes proactively.
• Track and report on RCM performance by payer; surface trends and risks and engage teams to improve.

Job description

Alma is looking for a Senior 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. This is a full time, fully remote position on our team. Occasional travel may be required for team or company events/meetings.

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