Clinical Program Manager

Remote, United States


As a Clinical Program Manager in our growing member engagement line of business, you will be at the forefront of improving patient outcomes by developing impactful outreach and health awareness programs implemented through Cotiviti’s leading Quality and Eliza Member Engagement solutions. Your role will center around engaging health plan members by designing best-practice based outreach campaign programs, closing care gaps based on HEDIS and Star quality measures, and working with our extensive list of health plan clients to drive value to their proactive member

health management programs.


  • Member Engagement Strategy:
    • Collaborate with cross-functional teams to design and implement standardized member engagement campaigns based on best practices for conducting efficient, targeted outreaches across multiple channels.
    • Leverage data from HEDIS quality measures to identify opportunities to develop care gap-driven campaigns and prioritize outreach efforts based on client objectives
    • Support creation of culturally competent
  • Health Awareness Programs:
    • Create educational content on preventive screenings, vaccinations, chronic disease management, and other key topics
    • Implement targeted initiatives to raise awareness among members about specific health conditions or community health support programs.
    • Collaborate with Quality and Eliza member engagement product teams to implement and execute these campaigns with our health plan partners.
  • Outreach Initiatives:
    • Design and execute outreach programs that resonate with diverse member populations.
    • Utilize multiple channels (IVR, email, SMS, etc.) to engage members effectively.
    • Monitor program effectiveness and adjust strategies based on real-time reporting and analytics.
  • Data-Driven Insights:
    • Analyze program data to identify trends and opportunities for new campaigns or interventions.
    • Work closely with data analysts to measure program impact and member engagement rates to further refine best practice standards and marketing proof points
    • Use insights to refine outreach strategies and improve outcomes.
  • Collaboration and Partnerships:
    • Engage with health plan partners, internal program SMEs, and market research teams to prioritize high-value member engagement opportunities.
    • Foster collaborative relationships to enhance member engagement processes and standards across internal teams.
    • Participate in cross-industry forums to stay informed about best practices.
  • Quality Metrics and Reporting
    • Support tracking of program performance metrics related to member engagement.
    • Generate regular reports for leadership, highlighting successes and areas for improvement.
    • Ensure compliance with regulatory guidelines and quality standards.



  • Bachelor’s degree in a relevant field (Master’s preferred).
  • 5+ years’ experience in healthcare member engagement, program design and development, or health education.
  • Passion for promoting preventive care and improving health outcomes for our client’s members. • Knowledge of HEDIS quality measures and their impact on member health.
  • Comfortable with project management principles (we are SAFe Agile) and directly supporting program operations leads as needed.
  • Ability to gain acceptance of recommendations made to other departments or individuals for internal and external business partners.
  • Consults on and applies knowledge, skills, tools, and techniques to execute projects effectively and efficiently in alignment with organizational competencies and strategic business goals.
  • Ability to articulate and document a scope, process, accountable owners, and project milestones and timelines with the support of the business lead. Includes summarizing project health and outcomes at any point in the project lifecycle.
  • Professional with the ability to properly handle PHI and confidential information.


Base compensation ranges from $85,000 to $105,000 per year. Specific offers are determined by various factors, such as experience, education, skills, certifications, and other business needs. 


Cotiviti offers team members a competitive benefits package to address a wide range of personal and family needs, including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, 9 paid holidays per year, and 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti. For information about our benefits package, please refer to our Careers page.


Date of posting: 6/10/2024

Applications are assessed on a rolling basis. We anticipate that the application window will close on 9/10/2024  but the application window may change depending on the volume of applications received or close immediately if a qualified candidate is selected.