Value-Based Care Program Manager

MASC Medical Recruitment Firm

Value-Based Care Program Manager managing healthcare initiatives for a value-based care portfolio. Leading case management teams to deliver measurable results and align with payer expectations.

Posted 7/1/2026full-timeSan Diego • California • 🇺🇸 United StatesMid-LevelSenior💰 $85,000 - $120,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in leading case management and population health initiatives, with a strong focus on quality frameworks and value-based care. Proven ability to mentor multidisciplinary teams and drive performance improvement through data-driven strategies.

Highest-signal resume keywords

Healthcare ManagementCase Management LeadershipValue-Based CareQuality Frameworks (HEDIS, NCQA, DHCS, CMS)Population Health Reporting

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

Case ManagementCare CoordinationPerformance Metrics ManagementWorkflow DesignData Analysis

Soft Skills

LeadershipCross-Functional CommunicationCoachingMentoringAnalytical Thinking

Tools & Technologies

Technology IntegrationsDashboard Interpretation

Certifications & Qualifications

RNLCSWCase ManagementCCM

Industry Keywords

Transitional CareHigh-Risk Population InitiativesMedi-CalMedicareHealth Plan Collaboration

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