Senior Program Manager

Job Description

Healthy Blue Care Together (HBCT) is partnering with the North Carolina Department of Health and Human Services to operationalize the Children and Families Specialty Plan (CFSP). CFSP is a single, statewide Medicaid Plan designed to provide seamless, integrated, and coordinated care to enrolled infants, children, youth, young adults, and families served and previously served by the child welfare system. HBCT is outcomes-driven and focused on ensuring that all members have access to quality services and benefits across North Carolina, addressing their physical health, behavioral health, pharmacy, intellectual/developmental, long-term services and supports, unmet health-related resource, and care management needs.

Job Profile Summary

The Senior Program Manager, in collaboration with the Principal Business Operations Advisor, will support monitoring and evaluation of key aspects of HBCT Plan execution, focusing on: Plan-based and delegated staffing and performance; clinical, care management, medication monitoring, psychosocial, and specialty program implementation; and provider network and service access equity and quality. The Senior Program Manager will support the development of data management and reporting strategies aligned with our Continuous Quality Improvement framework and Monitoring and Evaluation plan. The Senior Program Manager will collaborate with the Outcomes Monitoring and Evaluation Team to support population- and member-level outcomes monitoring and evaluation.

What You'll Do

• Develop project plans and recommendations in support of Plan objectives and leads implementation; tracks and reports on the status of the project.  Must ascertain, categorize and manage projects in relation to Plan priorities. 

• Coordinate data sharing and integration across systems to enable comprehensive performance analysis. 

• Use dashboards, team reporting, regulatory reports and other artifacts to develop Plan-level insights on Plan functions within Care Management, Provider Network, and Cross-collaboration teams.

• Track headwinds and tailwinds impacting overall program performance. 

• Ensure data accuracy and usability for decision-making. 

• Ensure timely execution of improvement plans and monitor progress against defined goals. Delegates assignments and monitoring progress as required to ensure a timely completion of deliverables.

• Coordinate development and implementation of policies and procedures as well as development of monitoring and evaluation benchmarks.

• Control and monitor project effectiveness, update project plans as necessary.  Ensure compliance with necessary audit requirements. 

• Assist with analysis and development of business processes to ensure quality, cost effectiveness, timeliness of customer service, and regulatory requirements and mandates are met. 

• Develop escalation process to channel issues and concerns to appropriate parties. 

• Evaluate project risks, develop contingency plans and respond to change in risk as the project progresses.<