Program Manager, Consultant
2 months ago
Your Role
The Medical Care Programs team is responsible for managing programs vendor-delivered programs to manage care and deliver benefits for our members. The Program Manager, Consultant will report to the Senior Manager, Select Benefits and Utilization Management. In this role you will provide clinical support for prior authorization for advanced imaging, spine surgery, interventional pain, and oncology. You will be a member of a small team responsible for managing the vendor(s) that deliver these services, driving value, managing performance, and maintaining regulatory compliance.
Your Work
In this role, you will:
Provide overall program leadership, guidance, and manage all aspects of a given program, including requirements gathering, business case creation, and implementation Develop resourcing strategies to ensure optimum support for projects and for the day-to-day operational activities Review program budget variance and scope change requests, and participate in the budget-resolution process Lead cross-functional meetings and foster teamwork; drive escalation and resolution of issues, while promoting collaboration and coordination across broad categories of stakeholders Support and coach project managers within the program, while providing technical expertise in planning, execution, and leadership of program, projects, and initiatives Participate in RFP's and vendor contracting Oversee delivery of services by vendors Perform, monitor and sustain compliance activities to ensure audit readiness at all times Be accountable for select performance outcomes, particularly in reducing cost of health care and improving member and provider experience Monitor performance, identify issues, and drive resolutionWe have other current jobs related to this field that you can find below
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