Clinical Operations Program Manager - Market Liaison

Job Summary:

The Clinical Operations Program Manager – Strategy and Implementation Market Liaison is responsible for managing clinical programs aligned to strategic objectives that include multiple projects within the Clinical Operations organization. Supports new business activities including assisting with the development of responses to Request for Proposals (RFPs) and implementation of care management programs in new markets, new products, new contracts and programmatic enhancements in existing markets.

Essential Functions:

• Responsible for successful delivery of Clinical Operations programs through the implementation of new programs and processes (contract renewals, new markets, new products and product enhancements).
• Support the development and management of clinical programs including data analysis to support the design, project plan development, workflow design, program tracking and implementation  
• Assist with the continuous improvement of program management best practices, processes, and tools
• Responsible for ensuring  program performance of Care Management activities are monitored and tracked as it relates to business growth and expansion
• Work closely with business executives and Director Care Management Liaisons to ensure assigned programs align with business strategies, regulatory/contract/accreditation requirements and are properly resourced, and managed
• Lead cross-functional teams
• Demonstrate and communicate the capabilities of CareSource’s clinical document system, how the system supports end to end care management workflows and opportunities for enhancement.
• Collaborate with Clinical Operations teams to ensure care management strategies in new markets/new products/contract renewals are implemented in the clinical documentation system (i.e., Guiding Care) in conjunction with the configuration team
• Collaborate with Training and Auditing teams on the development of new program materials and updates to existing training and auditing documents based on new program requirements
• Support new business activities including developing responses to Request for Proposals (RFPs) and new business implementation activities as needed
• Facilitate and drive Program Stakeholder meetings
• Provide regular reporting and maintain ongoing communications to senior management, stakeholders, and executive sponsors
• Track, compile, and report program metrics
• Responsible for management of program SharePoint site and program document repository
• Develop and produce detailed reports, business decision documents, meeting minutes, and notification for assigned programs
• Perform any other job duties as requested

Education and Experience:

• Bachelor’s Degree in health related field or equivalent years of relevant experience is required
• Master’s Degree in related field is preferred
• Minimum of five (5) years of healthcare experience is required
• Minimum of two (2) years of product or program management experience is required

Competencies, Knowledge and Skills:

• Excellent proficiency with Microsoft Office tools, including Project, Word, PowerPoint, Excel, Visio, Teams, Outlook, etc.
• Knowledge of clinical documentation system (Altruista Health/Guiding Care)
• Demonstrates skills related to system design, program and project/process improvement
• Demonstrates excellent analysis and reporting skills
• Strong data visualization and analytical skills
• Excellent decision making/problem solving skills
• Exceptional interpersonal and relationship building skills
• Excellent critical listening and thinking skills
• Proven ability to effectively interact with all levels of the organization of management within and externally to the organization
• Excellent written and verbal communication skills
• Customer service oriented
• Ability to shape the approach to needed results and gain consensus of the approach
• Proven ability to prioritize work and team assignments to deliver projects on time, on budget, and meeting stakeholders’ expectations
• Knowledge of Utilization Management (UM), Case/Care Management (CM) and Behavioral Health (BH) healthcare domain is required.
• Strong experience in the healthcare payer industry and knowledge of Medicaid and Medicare
• Ability to understand and implement regulatory, contract, and accreditation requirements
• Ability to work independently and within a team environment
• Ability to develop, prioritize and accomplish goals

Licensure and Certification:

• Project Management Professional (PMP) or equivalent certification/training is preferred; Program Management Certification (PgMP) is preferred
• Registered Nurse (RN) or other clinical licensure is preferred
• CCM preferred

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• High potential for remote work

Compensation Range:

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Organization Level Competencies

• Create an Inclusive Environment

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.