OH Market Program Management Director – Preferred Experience in Managed Care

Job not on LinkedIn

🔥 12 hours ago

🏈 Ohio – Remote

🏈 Ohio – Remote

💵 $113k - $197.7k / year

⏰ Full Time

🔴 Lead

📋 Program Manager

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CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• Assist the Vice President, Duals Products, with oversight of program implementations, compliance, operational performance, program growth, clinical and care management effectiveness, Quality and Affordability Initiatives pipeline development, and other program management activities • Lead Duals Program Management Operational activities across the OH Market from Program Management and Business Analysis perspectives • Establish strategies and goals to identify and mitigate program risks • Identify and assist with rapid resolution or escalation of program issues, blockers, and hindrances • Evaluate market-specific operational process effectiveness and manage process improvement activities with Enterprise, Duals, and Market Teams • Integrate continuous improvement and innovation into projects and initiatives • Develop, translate, and execute key strategies for functional and operational requirements • Apply industry standards, best practices, project management tools, and techniques to support market initiatives • Manage operational dependencies and risks across the Duals product initiative portfolio through change and risk management controls • Lead delivery of high-quality, consistent initiatives for OH members, providers, and program goals • Monitor performance across market Duals programs to leverage best practices and knowledge sharing and improve outcomes • Assess, manage, and control program scope, schedule, and budget change impacts • Work with business executives to align programs with business strategy and ensure appropriate funding, resourcing, and management • Drive cross-functional communication between impacted business and IT areas • Facilitate stakeholder meetings and represent programs in governance meetings • Review and approve program meeting minutes • Build working relationships with Integrated Dual Programs, market, and enterprise operations partners • Engage stakeholders to ensure alignment • Provide leadership and support for product expansion • Perform other job-related duties as requested

🎯 Requirements

• Bachelor's degree in project management, business, public health or related field required • Master's degree preferred • Equivalent years of relevant work experience may be accepted in lieu of required education • Six (6) years of government-regulated (Federal and/or State) health insurance products including Medicare, Medicaid, Managed Care Waiver, and FFS required • Six (6) years of project and program management experience required • Five (5) years of experience driving performance and process improvements in the health care insurance industry required • Demonstrated experience implementing programs with focus on integration required • Strong healthcare payer industry experience, including knowledge of Medicaid, Medicare, and government-regulated products • Comprehensive operational knowledge across member and provider functions, clinical operations, and sales/business development • Deep understanding of project management processes, tools, techniques, development lifecycles, and project management software • Ability to manage large, complex projects from start to finish, including budgets up to $10M+, cross-functional teams, core members, and multiple vendors • Strong organizational, time management, prioritization, and execution skills • Excellent analytical, reporting, decision-making, problem-solving, critical thinking, and critical listening skills • Ability to identify business problems, assess solutions, shape approaches, gain consensus, and understand business partner and stakeholder needs • Excellent written and verbal communication skills • Strong relationship-building, interpersonal, leadership, training, teaching, and change agent skills • Ability to work independently while keeping market leadership and key stakeholders informed • Business acumen, political astuteness, customer service orientation, and ability to act with diplomacy and sensitivity to cultural diversity • Hands-on proficiency with Microsoft Office tools, including Copilot AI, Project, Outlook, Word, PowerPoint, and Excel • Ability to think strategically, lead proactively and efficiently, and demonstrate a sense of urgency • No licensure or certification required • General office environment; may be required to sit or stand for extended periods • Flexible hours, including possible evenings and/or weekends as needed to serve members

🏖️ Benefits

• Bonus tied to company and individual performance may be available • Comprehensive total rewards package • Flexible hours, including possible evenings and/or weekends as needed • Travel is not typically required