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Senior Project/Program Manager
E-Verify ProgramLead design of population health strategies improving care coordination and outcomes at Blue Cross NC. Collaborate with stakeholders on program initiatives and monitor effectiveness while ensuring compliance.
Posted 6/3/2026full-timeDurham • Kentucky, Louisiana, Mississippi, South Carolina • 🇺🇸 United StatesSenior💰 $89,174 - $142,679 per yearWebsite
About the role
Key responsibilities & impact- Leads and oversees the design of population health strategy initiatives and programs to improve care coordination and health outcomes including developing efficiencies in programs (clinical and non-clinical)
- Works alongside senior leadership to monitor the effectiveness of care and identifying areas for process improvement to manage costs and to comply with federal and state regulations
- Collaborates closely with project team members, business owners and sponsors to develop, implement and monitor initiatives that can improve member health outcomes, reduce provider administrative burden, and/or reduce medical or operational expense through a variety levers, including clinical workflow innovation, operational efficiency, prior authorization management, and AI-enabled care
- Leads the development of population health strategies focused on advancing care coordination, improving health outcomes, and increasing program efficiency
- Gathers input from across the enterprise, division, community, members and through competitive intelligence to identify opportunities, assess needs and develop strategic design of solutions
- Ensures alignment of solutions across the enterprise
- Develops business cases, strategy concept designs and program requirements
- Serves as a subject matter expert, routinely briefing leaders and key stakeholders on program goals and initiatives
- Develops project plans and recommendations in support of compliance objectives and leads implementation
- Tracks and reports on the status of projects
- Assesses project risks, develops mitigation and contingency plans
- Identifies analyzes and understands target audiences and their specific program needs
- Develops and deploys marketing strategy to increase member engagement in maternal health programs
- Leads vendor identification, evaluation, selection and contract negotiations for new vendor relationships
- Works with senior leadership team to support clinical initiatives and/or programs are in accordance with National Committee for Quality Assurance (NCQA) guidelines, state mandates, and/or government contract requirements
- May work across multiple Line of Business and states to encompass program needs into population health strategies
- Establishes and monitors performance metrics and goals for assigned programs, including process measures, outcomes measures, financial measures and methodologies for implementing programs
- Documents and presents program results through operational reports, outcomes studies and presentations
- Owns and makes needed decisions to ensure the successful resolution of issues within the program to achieve milestones and program deliverables
- Incorporates evaluation planning into the overall strategy
- Establishes key performance indicators for programs, including process measures, outcomes measures and financial measures
- Ensure program is designed in such a way that these metrics can be collected and monitored
Requirements
What you’ll need- Bachelor's degree or advanced degree (where required)
- 5+ years of experience in related field (strategic planning and program management for health plan)
- In lieu of degree, 7+ years of experience in related field
- Preference for a background in quality, public health, healthcare administration, business and/or clinical background
Benefits
Comp & perks- The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community
- Work-life balance, flexibility, and the autonomy to do great work
- Medical, dental, and vision coverage along with numerous health and wellness programs
- Parental leave and support plus adoption and surrogacy assistance
- Career development programs and tuition reimbursement for continued education
- 401k match including an annual company contribution
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
program managementstrategic planningprocess improvementclinical workflow innovationoperational efficiencyprior authorization managementAI-enabled careperformance metricsrisk assessmentvendor management
Soft Skills
leadershipcollaborationcommunicationproblem-solvinganalytical thinkingdecision-makingstakeholder engagementproject planningmarketing strategy developmentevaluation planning