Value-Based Care Program Manager - Healthcare

mascmedical; San Diego (CA); Hybrid; USD 85,000 - 120,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Retirement

Paid vacation

CME/licensure reimbursement

Job summary

mascmedical in San Diego is seeking a Value-Based Care Program Manager to lead operational initiatives in value-based care. This role involves mentoring teams, managing case management programs, and collaborating with health plans to advance care quality.

The ideal candidate will have over 5 years in healthcare management, a relevant Bachelor’s degree, and strong leadership skills. Compensation ranges from $85,000 to $120,000 annually with hybrid work options.

Qualifications

• 5+ years in healthcare management, with at least 3 years leading case management or population-health teams.
• Experience managing a team of 5 or more.
• Strong background in value-based care and health plan collaboration.

Responsibilities

• Lead the development and execution of case management programs.
• Direct and mentor a multidisciplinary team to ensure excellence in care delivery.
• Manage quality, utilization, and cost metrics across payer contracts.

Skills

Leadership

Analytical skills

Cross-functional communication

Healthcare management

Value-based care expertise

Education

Bachelor's degree in Nursing, Social Work, Public Health, or Healthcare Administration

Master’s degree (preferred)

Tools

HEDIS

NCQA

DHCS

CMS

Job description

Value-Based Care Program Manager San Diego (Hybrid)

The Value-Based Care Program Manager is a key member of the leadership team. This role leads operational and strategic initiatives across our value‑based care portfolio — driving performance, leading case management teams, and ensuring alignment between clinical excellence, quality outcomes, and payer expectations. This position requires a balance of visionary leadership and tactical execution: you’ll build, refine, and scale case management‑centric programs that deliver measurable results — while mentoring teams and collaborating with health plans, data teams, and executive leadership to advance our value‑based mission.

Compensation & Benefits

$85,000 – $120,000 annually (DOE). Medical, dental, and vision coverage; retirement; paid vacation; CME/licensure reimbursement. Hybrid/remote flexibility with periodic in‑person collaboration.

Responsibilities

• Lead the development and execution of case management and wrap‑around programs supporting ECM, transitional care, and high‑risk population initiatives.
• Direct, coach, and mentor a multidisciplinary team (RN, LCSW, CHW, non‑clinical navigators) to ensure accountability, engagement, and excellence in care delivery.
• Manage quality, utilization, and cost metrics across multiple payer contracts; identify performance trends and lead improvement initiatives.
• Design scalable workflows, standard operating procedures, and technology integrations that enhance care coordination and compliance.
• Serve as the primary operational liaison to health plans — representing the company and performance‑improvement discussions.
• Partner with analytics to translate insights into action, shaping strategies around HEDIS, TCM, ECM, and STAR measures.
• Drive adoption of new initiatives, training, and policy updates across case management and quality teams.
• Provide executive‑level reporting, dashboard interpretation, and performance summaries to support leadership decision‑making.

Requirements

• Bachelor’s degree in Nursing, Social Work, Public Health, or Healthcare Administration (Master’s preferred).
• 5+ years in healthcare management, including at least 3 years leading case management or population‑health teams. (Managed a team of 5 or more).
• Strong background in value‑based care, risk adjustment, or health plan collaboration.
• Expertise in quality frameworks (HEDIS, NCQA, DHCS, CMS) and population health reporting.
• Exceptional leadership, analytical, and cross‑functional communication skills.
• Demonstrated success building or scaling care management programs within Medi‑Cal or Medicare settings.
• Preferred Certifications: RN, LCSW, Case Management, or CCM.