Program Manager III

🔥 18 hours ago

🗽 New York, Missouri – Remote

🗽 New York – Remote 🏰 Missouri – Remote

💵 $87.7k - $157.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Program Manager

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Drive strategic healthcare transformation initiatives across health plan operations • Identify opportunities to improve clinical and operational performance, member outcomes and experience, healthcare costs, and regulatory and contractual compliance • Lead concurrent initiatives from opportunity identification and business case development through implementation and performance measurement • Partner with clinical operations, Medical Economics, Finance, IT, Product, Provider/Network teams, Payment Integrity, and other cross-functional stakeholders • Evaluate healthcare quality, clinical and operational efficiency, member outcomes, service levels, regulatory compliance, and medical cost performance • Lead initiatives across Utilization Management, Care Management, Behavioral Health, LTSS, Clinical Operations, and other payer operations • Analyze healthcare utilization and cost trends, identify drivers and opportunities, develop business cases, and establish performance measures • Translate healthcare data and operational findings into strategies, project plans, and measurable interventions • Develop cost-saving strategies and facilitate prioritization, leadership alignment, and resource allocation • Manage projects through discovery, requirements gathering, planning, implementation, measurement, and transition to operational ownership • Establish objectives, milestones, deliverables, dependencies, risks, decision points, performance measures, governance, and documentation • Lead cross-functional workgroups and drive decisions and defined outcomes • Translate business and clinical requirements into technology-enabled solutions and ensure implementation and adoption • Monitor post-implementation performance, validate realized impact, and identify continued improvement opportunities • Communicate project status, risks, financial opportunities, decisions, and performance to senior and executive leadership • Negotiate with stakeholders to secure resources, resolve issues, mitigate risks, and maintain progress • Maintain knowledge of managed care operations, healthcare trends, regulatory requirements, and Medicaid considerations

🎯 Requirements

• Bachelor’s degree in Healthcare Administration, Business Administration, or related field, or equivalent relevant experience • 5+ years project implementation, product or program management experience • Experience within a healthcare payer or managed care organization strongly preferred • Knowledge of Medicaid and/or other government-sponsored health programs preferred • Understanding of healthcare payer operations and the relationship between clinical operations, healthcare utilization, medical cost, quality, regulatory requirements, and financial performance preferred • Experience partnering with Medical Economics, healthcare analytics, Finance, or similar functions preferred • Experience leading complex, cross-functional healthcare initiatives preferred • Strong executive communication, facilitation, critical thinking, and problem-solving skills preferred • Project management certification (PMP, PgMP) and/or healthcare-related credentials preferred but not required • Must be authorized to work in the U.S. without employment-based visa sponsorship now or in the future

🏖️ Benefits

• Competitive pay • Health insurance • 401K • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation • Diversity-focused equal opportunity workplace