Clinical Program Manager

The Clinical Program Manager is responsible for the strategic design, implementation, and ongoing management of clinical programs within the health plan to improve quality, member outcomes, regulatory compliance, and cost-effectiveness. This role leads and supports the collection, analysis, and reporting of data and the development of intervention strategies in support of advancing the organization’s clinical strategy.

What You Will Do

Lead the development, implementation, and optimization of clinical programs across medical, pharmacy, and population health domains, analyze available industry data, trends, and best practices to leverage for organization clinical strategy development, and identify and communicate risk areas and barriers that could inhibit the organization’s ability to achieve clinical program goals.

Why It Might Be a Fit

The Clinical Program Manager should bring intellectual curiosity, proven data analytics skills, and problem-solving to deepen insights into the factors that drive health care quality, costs, and equity. This role requires excellent interpersonal skills, including the ability to work across the organization and externally and to interact, influence and negotiate effectively at all levels of management.

Requirements

• Active, unrestricted clinical license in the state of Rhode Island
• Registered Nurse (RN) or Doctor of Pharmacy (PharmD)
• Five (5) + years’ experience working in healthcare, with substantial knowledge of the health system and provider environment
• Demonstrated experience designing, implementing, and managing clinical programs
• Strong understanding of care management, quality programs, and population health management
• Experience working with health care analytics, regulatory requirements, and project management
• Experience working with statistical analysis of complex health care data sets, including health care claims and health outcomes data, to support improvement activities
• Proven ability to analyze data, interpret trends, and translate insights into actionable program improvements
• Demonstrated ability to develop written reports inclusive of qualitative and quantitative analysis outlining conclusions and recommendations for improvement
• Excellent interpersonal skills, including the ability to work across the organization and externally and to interact, influence and negotiate effectively at all levels of management
• Ability to work independently with minimal supervision
• Effective communication skills, both verbal and written
• Outstanding time management and organizational skills
• Demonstrated ability to manage multiple initiatives simultaneously in a deadline driven environment
• Proficiency in Microsoft Office

Benefits

• Healthcare
• PTO
• Retirement
• Learning budget
• Parental leave
• Wellness
• Equity