Program Manager III – Utilization Management

Job not on LinkedIn

🔥 2 minutes ago

🏄 California, Florida, +13 more states – Remote

🏄 California – Remote 🐊 Florida – Remote 🌽 Illinois – Remote 🌾 Nebraska – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote 🤠 Texas – Remote ⚔️ Virginia – Remote ☕ Washington – 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

• Promote increased program efficiency, service levels, and value by monitoring performance and identifying improvement opportunities • Plan, organize, monitor, oversee, and lead multiple concurrent projects using cross-functional teams • Lead end-to-end implementation of technology solutions supporting Utilization Management • Translate business and clinical requirements into scalable, well-governed system deployments • Drive delivery from design through go-live and post-launch stabilization • Partner with clinical, operational, and IT teams to configure, test, and adopt new capabilities • Identify opportunities to improve efficiency, service levels, regulatory compliance, and technology-enabled processes • Develop strategies, prioritize improvements, align resources, and support workflow transformation initiatives • Manage requirements gathering, solution design, project plans, schedules, resources, budgets, system configuration, user acceptance testing, deployment, and go-live activities • Use project management tools and techniques to establish governance and controlled implementation approaches • Maintain project documentation including action items, issues, risks, success metrics, testing documentation, and readiness materials • Communicate project status through executive summaries, presentations, dashboards, and reports • Negotiate resources, resolve issues, mitigate risks, and align business, technology, operational, and vendor teams • Lead solution design sessions, governance reviews, testing activities, and implementation readiness discussions • Translate complex technical concepts, risks, and recommendations for diverse stakeholders • Define and track success metrics, implementation outcomes, and business value realization

🎯 Requirements

• Bachelor’s degree in Business Administration, Healthcare Administration, related field, or equivalent experience • Master’s degree preferred • 5+ years project implementation, product or program management experience • Managed care or prescription benefit management experience preferred • Strong project management and analytical skills • High attention to detail • Proven track record of successful project deliveries at the enterprise level • Candidates must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future • Sponsorship and future sponsorship are not available, including H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT

🏖️ Benefits

• Competitive pay • Health insurance • 401K plan • 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