Clinical Program Manager - Remote

About the role

This role will drive complex programs from planning through execution with a focus on structure, accountability, and measurable delivery. You will work across business leaders, delivery teams, and strategic partners to align priorities, manage dependencies, and keep initiatives on track. The position offers the opportunity to bring clarity to complex work and deliver outcomes that matter across the organization within a healthcare environment.

Location: Remote - US based candidates only, no visa sponsorship available.

Responsibilities

• Lead development of clinical programs and operational reports
• Convert organizational strategy into actionable case management plans
• Improve case management workflows to enhance member engagement
• Optimize data reporting for tracking program metrics
• Monitor program performance against KPIs to gauge success
• Ensure compliance with TriCare, CMS, NCQA, and other regulations
• Collaborate with cross-functional leaders to implement care model initiatives
• Create communication tools to support program development

Qualifications

• Bachelor's Degree in Health Science, Nursing or related field required
• Master's degree in Business Administration (MBA), Healthcare Administration (MHA), or Public Health (MPH) preferred
• 10 years' experience in healthcare, focusing on Program Management and process improvement
• Experience in data analysis for program design and monitoring
• Experience evaluating financial and clinical performance metrics
• Preferred experience in Medicare Advantage and TRICARE
• Proficiency in NCQA case management accreditation standards and HEDIS quality metrics

Pay

$114,957 – $142,006 annually

Benefits

• Medical, dental, and vision insurance
• Retirement savings with employer contributions
• Paid time off including volunteer time off
• Unique employee benefits like pie day
• Well-rounded compensation package with potential incentives