Program Manager

Key Responsibilities

• Partners with the Account Director to oversee overall program performance, provide strategic direction, manage client relationships, and represent program operations in recurring client meetings, business reviews, audits, and strategic planning sessions
• Directs day-to-day program operations through close collaboration with supervisors and team leads, providing guidance, coaching, and performance support while ensuring effective escalation management and resolution of complex issues impacting patients, providers, or clients
• Maintains compliance with client requirements, regulatory standards, and internal policies, and actively addresses performance gaps through corrective action plans
• Proactively identifies operational risks, trends, and gaps; develops and implements mitigation strategies; and leads timely resolution of escalated or high-impact issues to minimize disruption and protect service quality
• Drives continuous process improvement initiatives to enhance efficiency, quality, and client satisfaction, while developing, refining, and maintaining SOPs, workflows, and business rules aligned with operational best practices
• Analyzes program data and reporting to generate actionable insights, informs decision-making, supports forecasting and capacity planning, and provides clear, data-driven recommendations to clients and internal leadership
• Collaborates with internal teams including QA, Training, IT, and Operations to optimize program performance, support onboarding of new programs, and contribute to workflow design, system implementations, resource planning, and training coordination

Qualifications

• Education: High school diploma or equivalent (Required) Bachelor’s degree (Preferred)
• Experience: 5–7 years of healthcare, reimbursement, or patient support program experience (Required) 2–3 years of program management, operations, or leadership experience (Required)
• Experience working directly with clients in a healthcare or vendor environment (Preferred) Experience with CRM and case management systems (Preferred)
• Knowledge, Skills, & Abilities: Knowledge of medical and pharmacy benefits, prior authorizations, appeals, and reimbursement processes (Required) Advanced critical thinking and problem-solving skills (Required) Excellent written, verbal, and interpersonal communication skills (Required) Strong analytical, interpretation, and data-driven decision-making skills (Required) High level of organizational and attention to detail skills (Required) Advanced business software and applications Microsoft Office (Excel, PowerPoint, Word), etc. (Required) Ability to manage and strengthen client relationships through clear communication, trust-building, and proactive engagement (Required) Ability to manage multiple programs and priorities in a fast-paced environment (Required) Ability to lead process improvement initiatives (Required)