Senior Project/Program Manager

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Lead 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

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

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

Tools & Technologies

NCQA guidelinesoperational reportsoutcomes studiesbusiness case developmentcontract negotiationhealthcare administration toolsdata analysis toolsproject management softwareperformance tracking systemsmember engagement platforms

Industry Keywords

population health strategyhealth outcomescare coordinationhealth planpublic healthquality assurancehealthcare administrationclinical programsgovernment contract compliancefinancial measures

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