Clinical Program Manager

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The Clinical Program Manager is responsible for identifying, managing and tracking clinical, quality, correct coding, documentation and data submission projects that advance the objectives of the Health Plan's strategic goals. The Clinical Program Manager facilitates the development of internal and external reports and the delivery of data as needed to support and monitor the action plans to accomplish the Triple Aim:
1) improve member experience,
2) improve the quality of care, and
3) reduce health care costs.

• Manage and track clinical projects that advance the objectives of the strategic plan with key provider groups and/or hospital systems by supporting established committees and creating new work teams; including organizing and publishing agendas, documenting minutes, maintaining work plans and monitoring open action items.
• Work 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 to execute initiatives.
• Serve as project leader for cross‑functional initiatives that drive performance improvement, engaging across functional teams as needed to ensure effective communication of project requirements and track progress of action plans.
• Facilitate the development of clinical reports and deliver data to key provider partners; also develop internal reports to demonstrate progress.
• Perform detailed analysis of data, workflows, policies, procedures, and organization of staff to execute initiatives.
• Use project management software to support initiatives.
• Perform other duties as assigned.
• Comply with all policies and standards.

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 of managed care, hospital or medical group experience, focusing on quality improvement, utilization management, or clinical operations. Experience analyzing and presenting data to drive outcomes and making presentations in group settings. At least two years of project management experience managing a project at any level in a medical group, IPA or health plan setting.

Licensed behavioral health clinician (LMFT, LCSW, LPC, Psychologist) or RN with experience in a psychiatric setting required.

Pay Range: $86,000.00 – $ per year.

Centene offers a comprehensive benefits package including competitive pay, health insurance, 401(k) 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. Actual pay will be adjusted based on an individual's skills, experience, education, and other job‑related factors permitted by law, including full‑time or part‑time status.

Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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.

Not Applicable

Full-time

Project Management and Information Technology

Hospitals and Health Care and Insurance