Program Manager, Clinical Insights

WellSense Health Plan is a growing regional health insurance company with a 25-year history of providing health insurance that works for our members. The Program Manager, Clinical Insights is responsible for implementing and managing programs aimed at improving health outcomes and financial performance through collaboration with various clinical stakeholder groups.

Responsibilities:

• Implement and manage member health promotion programs associated with NCQA Population Health Management standards, and general member health and wellness programs designed to improve health outcomes and reduce inappropriate utilization, including pilots and new program design interventions
• Lead performance improvement projects associated with annual Performance Improvement budget and corporate goals, assembling stakeholders to design, execute, and monitor projects
• Manage and drive execution on outbound campaigns and selective member outreach, partnering with Care Management teams and Quality
• Key point of contact to engage with marketing on overall clinical, member facing information
• Support centralization of active member outreach by various teams
• Support program monitoring through the use of analytic dashboards and KPIs

Requirements:

• Bachelor's degree or equivalent combination of education and relevant experience in a health plan setting required
• 3+ years of healthcare/managed care experience
• 3+ years in program management, healthcare operations, or other applicable work experience
• Managed care experience in NCQA accreditation, care management, population health, or quality programs
• Successful completion of pre-employment background check
• Exceptional written and oral communication skills
• Excellent organizational skills and attention to detail
• Demonstrated ability to work independently and manage multiple complex projects simultaneously
• Proactive, motivated, and a collaborative team player
• Demonstrated ability to adapt quickly to changing priorities
• Strong critical thinking, analytical, and problem-solving skills
• Proficiency with MS tools including Word, Excel, PowerPoint, Visio and MS Project
• Demonstrated ability of managing competing priorities as well as stakeholders with differing objectives/perspectives
• Master's degree in business or health related/public health field preferred