Program Manager III, Clinical Operations

Community Health Plan of Washington

Program Manager overseeing Care Management programs at Community Health Plan of Washington. Leading operational efficiency and compliance initiatives while collaborating with senior leadership.

Posted 6/19/2026full-timeRemote • Washington • 🇺🇸 United StatesMid-LevelSenior💰 $93,200 - $148,190 per yearWebsite

About the role

Key responsibilities & impact

Develop and foster relationships with senior Care Management leadership through ongoing collaboration on process improvement initiatives related to operational efficiency, workflow management, and analytical support.
Oversee departmental projects, including identifying initiatives, developing project plans and timelines, and managing project work through completion.
Lead interdepartmental meetings, serving as a subject matter expert and educator to promote cross functional understanding of Care Management workflows and processes.
As needed, oversee and conduct regular internal audits of clinical staff performance, evaluating adherence to Care Management standards, regulatory requirements, and organizational policies, and provide feedback on performance gaps to staff leadership.
Ensure Care Management training meets all standards set forth by the National Committee for Quality Assurance, Healthcare Authority, Centers for Medicare and Medicaid Services, and other applicable regulatory bodies.
Collaborate with leadership to develop and implement new programs and enhance existing programs, including participation in and leadership of division-level initiatives in addition to Care Management-specific activities
Participate in internal cross functional teams to ensure care management programs meet regulatory and compliance requirements.
Serve as a resource and support for more junior Program Managers, delegating responsibilities as appropriate to help broaden team skillsets and balance work efforts within the department.
Serve as a liaison between data analytics staff and Care Management leadership to develop or modify care management reports used to assess productivity and program outcomes.
Produce care management reports and present findings to applicable leadership and or committees.
Identify opportunities to standardize and improve care management processes and partner with leadership and staff to implement efficient desk procedures across lines of business.
Perform other duties as assigned.

Requirements

What you’ll need

Have a bachelor’s degree or an equivalent combination of education and highly relevant experience.
Have a minimum of five (5) years of experience in program management administration, including developing and/or implementing programs or leading teams that develop and implement programs in a healthcare setting
Have at least three (3) years of experience in care management operations in a program management and or process improvement role, and one (1) or more years of mentoring, training, or teaching experience.
Possess current, unrestricted licensure in the State of Washington as a Registered Nurse or as a Licensed Independent Clinical Social Worker.
Have experience using Microsoft Office products, care management workflows, software applications, and reporting tools.

Benefits

Comp & perks

Medical, Prescription, Dental, and Vision
Telehealth app
Flexible Spending Accounts, Health Savings Accounts
Basic Life AD&D, Short and Long-Term Disability
Voluntary Life, Critical Care, and Long-Term Care Insurance
401(k) Retirement and generous employer match
Employee Assistance Program and Mental Fitness app
Financial Coaching, Identity Theft Protection
Time off including PTO accrual starting at 17 days per year
40 hours Community Service volunteer time
10 standard holidays, 2 floating holidays
Compassion time off, jury duty

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

program managementprocess improvementworkflow managementdata analyticsinternal auditscare management reportingperformance evaluationregulatory compliancetraining developmentproject planning

Soft Skills

relationship buildingcollaborationleadershipcommunicationmentoringeducatingcross-functional understandingdelegationproblem-solvingorganizational skills

Certifications

Registered NurseLicensed Independent Clinical Social Worker