Program Manager III - Payer and Network Strategies

Job Title
Program Manager III - Payer and Network Strategies

Location
Cleveland

Facility
Cleveland Clinic Main Campus

Department
Payer and Network Strategies-Finance

Job Code
T31030

Shift
Days

Schedule
8:00am-5:00pm

Job Summary

Job Details

As Program Manager III, you will manage the implementation and ongoing maintenance of designated programs, developing systems and procedures to ensure efficiency and effectiveness. In this role, you will oversee two to three state and federal value-based care contracts with Medicaid and Medicare, serving as a subject matter expert on contract performance and analytics. You will analyze performance data to identify gaps, collaborate with clinical teams to develop strategies for meeting contractual metrics, and prepare presentations to communicate findings and progress. This position serves as a liaison between the department and external communities, provides coaching and mentorship to staff, and participates in the budgetary process to support program goals.

A caregiver in this role works days from 8:00 a.m. - 5:00 p.m.

The position is primarily remote, with Independence FHC as the primary on-site location for monthly visits.

Additional on-site visits to other facilities may be required based on business needs.

A caregiver who excels in this role will:

• Develop, implement, manage, and maintain operational systems and activities.

• Serve as a liaison with all levels of the organization and outside the community.

• Manage multiple priorities and projects with competing deadlines.

• Allocate time to meet completion requirements.

• Serve as a coach and mentor for other positions in the department.

• Review and monitor adherence to Human Resources policies and corporate compliance procedures.

• Other duties as assigned.

Minimum qualifications for the ideal future caregiver include:

• Bachelor's degree in Business Administration, Healthcare Administration or related field and five years of related experience

• OR Master's degree and four years of experience

• Knowledge of statistical and financial analysis, primary research and business plan development

• Strong presentation, communication and training skills
• Value based care experience

Preferred qualifications for the ideal future caregiver include:

• Master's degree
• Healthcare experience
• Experience handling health insurance contracts
• Business analytics experience
• Experience using Copilot, Tableau, and Power Automate

Physical Requirements:

• Ability to communicate and exchange accurate information.
• Ability to perform work in a stationary position for extended periods.
• Ability to work with physical records or operate a computer or other office equipment.
• In some locations, ability to travel throughout the hospital system.
• In some locations ability to move up to 25 lbs.

Personal Protective Equipment:

• Follows Standard Precautions using personal protective equipment as required for procedures.