Value-Based Care Program Manager - Healthcare

Value-Based Care Program Manager

This position requires a balance of visionary leadership and tactical execution: you’ll build,  refine, and scale case management-centric programs that deliver measurable results — while mentoring teams and collaborating with health plans, data teams, and executive leadership to  advance our value-based mission. 

• $85,000 – $120,000 annually (DOE).
  

• Medical, dental, and vision coverage; retirement; paid vacation; CME/licensure  reimbursement. 
  

• Hybrid/remote flexibility with periodic in-person collaboration.
  

Responsibilities  

• Lead the development and execution of case management and  wrap-around programs supporting ECM, transitional care, and high-risk population  initiatives. 
  

• Direct, coach, and mentor a multidisciplinary team (RN, LCSW,  CHW, non-clinical navigators) to ensure accountability, engagement, and excellence in  care delivery. 
  

• Manage quality, utilization, and cost metrics across multiple  payer contracts; identify performance trends and lead improvement initiatives.
  

• Design scalable workflows, standard operating procedures, and  technology integrations that enhance care coordination and compliance.
  

• Serve as the primary operational liaison to health plans — representing the company and performance-improvement discussions.
  

• Partner with analytics to translate insights into action, shaping  strategies around HEDIS, TCM, ECM, and STAR measures. 
  

• Drive adoption of new initiatives, training, and policy updates  across case management and quality teams. 
  

• Provide executive-level reporting, dashboard interpretation,  and performance summaries to support leadership decision-making.
  

Requirements 

• Bachelor’s degree in Nursing, Social Work, Public Health, or Healthcare  Administration (Master’s preferred).
  

• 5+ years in healthcare management, including at least 3 years leading case  management or population-health teams. (Managed a team of 5 or more)
  

• Strong background in value-based care, risk adjustment, or health plan collaboration.
  

• • Expertise in quality frameworks (HEDIS, NCQA, DHCS, CMS) and population health  reporting.
  

• Exceptional leadership, analytical, and cross-functional communication skills.
  

• Demonstrated success building or scaling care management programs within Medi-Cal or  Medicare settings.
  

• Preferred Certifications: RN, LCSW, Case Management, or CCM.