Value-Based Care Program Manager – Healthcare

MASC Medical Recruitment Firm

Value-Based Care Program Manager managing case management initiatives across value-based care portfolio. Leading strategic operations and driving performance in San Diego healthcare setting.

Posted 6/1/2026full-timeSan Diego • California • 🇺🇸 United StatesMid-LevelSenior💰 $85,000 - $120,000 per yearWebsite

About the role

Key responsibilities & impact

Lead the development and execution of case management and wrap-around programs supporting ECM, transitional care, and high-risk population initiatives
Direct, coach, and mentor a multidisciplinary team (RN, LCSW, CHW, non-clinical navigators) to ensure accountability, engagement, and excellence in care delivery
Manage quality, utilization, and cost metrics across multiple payer contracts; identify performance trends and lead improvement initiatives
Design scalable workflows, standard operating procedures, and technology integrations that enhance care coordination and compliance
Serve as the primary operational liaison to health plans — representing the company and performance-improvement discussions
Partner with analytics to translate insights into action, shaping strategies around HEDIS, TCM, ECM, and STAR measures
Drive adoption of new initiatives, training, and policy updates across case management and quality teams
Provide executive-level reporting, dashboard interpretation, and performance summaries to support leadership decision-making

Requirements

What you’ll need

Bachelor’s degree in Nursing, Social Work, Public Health, or Healthcare Administration (Master’s preferred)
5+ years in healthcare management, including at least 3 years leading case management or population-health teams
Strong background in value-based care, risk adjustment, or health plan collaboration
Expertise in quality frameworks (HEDIS, NCQA, DHCS, CMS) and population health reporting
Exceptional leadership, analytical, and cross-functional communication skills
Demonstrated success building or scaling care management programs within Medi-Cal or Medicare settings
Preferred Certifications: RN, LCSW, Case Management, or CCM.

Benefits

Comp & perks

Medical, dental, and vision coverage
Retirement
Paid vacation
CME/licensure reimbursement
Hybrid/remote flexibility with periodic in-person collaboration

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

case managementwrap-around programsquality metricsutilization metricscost metricsworkflow designtechnology integrationHEDISTCMSTAR measures

Soft Skills

leadershipcoachingmentoringaccountabilityengagementanalytical skillscross-functional communicationtrainingpolicy updatesexecutive-level reporting

Certifications

RNLCSWCase ManagementCCM