Program Manager

• Develop and implement the operational support structure the core Retail Americas team needs to execute an ambitious roadmap across LATAM, Canada, and select emerging U.S. channel opportunities.
• Own specific Retail Americas programs running the full program lifecycle end-to-end: roadmap, resourcing, risk, and stakeholder management.
• Lead cross-functional coordination with Sales, Marketing, Finance, Operations, IT, Legal, and Logistics to ensure seamless execution of market entry and retail programs
• Identify and assess risks specific to emerging market launches — regulatory, logistical, cultural — and develop mitigation strategies to minimize impact
• Serve as the primary point of contact for program-related matters with internal stakeholders and external retail partners in market
• Track key performance metrics across owned programs and provide regular reporting to senior leadership
• Drive continuous improvement by identifying operational gaps and implementing scalable processes and tools across markets

Program Management Lead, Emerging Markets

• You will own multi-million-dollar capital expenditure (CapEx) budgets, negotiate with external automation and general contractors, and ensure aggressive timelines match our hyper-growth trajectory.
• You will pioneer the integration of advanced automation (e.g., AS/RS, robotics, complex conveyor systems) to radically maximize density and throughput.
• You will lead complex layout overhauls utilizing advanced CAD/SketchUp modeling integrated with predictive data analytics.
• You will establish robust engineering metrics, predictive throughput models, and centralized Power BI/SQL frameworks.
• You will manage high-value vendor relationships, negotiate service-level agreements (SLAs), and foster cross-functional alignment to mitigate deployment risks.

Senior Program Manager – Industrial Engineer

• Support a portfolio of 40+ Kiva Hub partners and their Capital Access Managers (CAMs).
• Onboard, train, coach, and support partners as they launch, grow, and sustain community-based lending programs.
• Serve as a primary point of contact for partner questions, troubleshooting, and technical assistance.
• Monitor partner performance and portfolio health, providing proactive recommendations and interventions when needed.
• Review and underwrite loan applications using Kiva's social underwriting methodology.
• Conduct fraud checks and pre-disbursement reviews.
• Monitor repayment performance and implement strategies to improve portfolio quality and repayment rates.

Program Associate, Entrepreneurial Ecosystems & Operations

• Serve as the primary point of contact with CMS on Program Integrity operations, including status reporting, project initiation within required timelines (10 business days), issue escalation, and delivery of Initial and Final Project Reports per SOW requirements; notify CMS within 24 hours prior to engaging external stakeholders in the absence of a Joint Operating Agreement.
• Own and administer the quality assurance and inter-rater reliability process for all Program Integrity medical record reviews, including development of QA protocols, peer review assessments, and corrective action procedures; maintain a 95% or greater accuracy score each month.
• Direct clinical reviewers to identify potential FWA indicators in medical records, including falsified documentation, altered records, billing pattern anomalies, medically unnecessary services, and evidence of patient harm; ensure review findings are documented consistent with CMS and FIG standards.
• Directly supervise and manage the clinical review team (RN, LPN, coder, and support staff), including hiring, onboarding, performance management, workload distribution, and ongoing training.
• Analyze Medicare claims data and medical record documentation to identify FWA patterns, billing anomalies, provider-specific trends, and program vulnerabilities; develop lead recommendations and supporting data for submission to CMS for consideration of additional review projects or referrals.
• Maintain current working knowledge of Medicare coverage rules, CMS Program Integrity Manual (IOM 100-8), Unified Case Management (UCM) system procedures, UPIC coordination protocols, and applicable law enforcement referral standards governing fraud-focused medical review activities.
• Lead the Program Integrity medical review workstream, including coordination with UPICs, law enforcement agencies, state agencies, and other external stakeholders as directed by CMS; ensure all referrals, overpayment recoupments, and field work are executed in compliance with SOW requirements and FIG protocols.

Medical Review Manager – Program Integrity, RN, BSN, MSN required

• Serve as primary liaison with Government stakeholders.
• Manage project schedule, budget, risks, and deliverables.
• Lead Agile delivery teams.
• Coordinate modernization, migration, testing, deployment, and operations.
• Prepare executive briefings and status reports.
• Ensure compliance with federal standards and contract requirements.
• Manage overall contract performance
• Develop and maintain the Project Plan within 10 days of award
• Lead weekly status meetings and reporting
• Manage schedule, risks, budget, resources, and deliverables
• Coordinate stakeholder engagement and approvals
• Oversee discovery, design, development, testing, deployment, and sustainment
• Coordinate with client leadership and cybersecurity teams
• Manage subcontractors and cloud providers

• Own and manage multiple sales programs end-to-end, ensuring alignment with business objectives and measurable performance goals
• Monitor program health using key metrics (lead flow, pipeline progression, conversion rates) and drive continuous improvement initiatives
• Deliver recurring and ad hoc reporting to provide clear visibility into sales performance and program outcomes
• Analyze pipeline and program data to identify trends, gaps, and opportunities, and translate findings into actionable recommendations
• Partner with Sales leadership to improve pipeline effectiveness and inform data-driven decision-making
• Ensure data accuracy, consistency, and integrity across reporting and dashboards
• Leverage Salesforce and BI tools to build and optimize reporting, dashboards, and performance tracking
• Collaborate with cross-functional stakeholders to enhance reporting capabilities and improve data accessibility and usability

Project/Program Manager

• Develop and maintain the health plan’s provider education program for coding, documentation, and billing integrity issues
• Establish program workflows, referral criteria, outreach templates, monitoring schedules, escalation pathways, and reporting standards
• Create standardized processes for provider identification, educational intervention, follow-up review, and referral to SIU when concerning behavior persists
• Analyze claims, coding, utilization, reimbursement, and provider billing data to identify outlier patterns
• Conduct targeted reviews to determine whether provider billing patterns warrant education or further escalation
• Draft and issue provider education letters that clearly describe identified billing concerns
• Conduct provider outreach calls and meetings to review findings, explain coding or documentation expectations, answer questions
• Perform quarterly and semiannual post-education monitoring to assess whether provider billing behavior changes
• Develop and administer a formal referral process to SIU for providers whose billing patterns do not improve

Provider Education Program Manager – Payment Integrity

• Curate, design and develop engaging content in multiple formats (e.g., workshops, e-learning, microlearning) that meet business and employee needs, including onboarding, technical skills, leadership development, safety and compliance training.
• Facilitate interactive, results-oriented learning sessions across diverse audiences.
• Track training projects from ideation through completion, managing timelines, resources, and deliverables to ensure high-quality outcomes on schedule.
• Coordinate with cross-functional teams to ensure clarity, consistency, and momentum across shared projects.
• Maintain a strong understanding of company priorities and L&D trends to ensure initiatives are innovative and support long-term goals and culture.
• Partner with Subject Matter Experts to assess skill gaps and to collaborate on learning solutions that align training to workforce needs.
• Manage the Learning Management System (LMS) to ensure employees have access to relevant, high-quality resources.
• Track and report on training effectiveness using assessments, feedback, and business KPIs and use data analytics to continuously improve learning experiences.
• Promote inclusivity and accessibility in all learning initiatives.

L&D Program Manager

• 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

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