Description
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: The Program Manager is responsible for leading assigned Utilization Management (UM) initiatives, governance processes, and program execution across a complex, multi-product, multi-market environment—serving as a trusted partner to UM operations and leadership. This role brings structure, prioritization, critical thinking, and operational discipline to a broad portfolio of initiatives, requests, and performance improvement efforts, spanning program planning, cross-functional execution, intake management, operational readiness, and executive reporting. Operating with a high degree of autonomy, the Program Manager translates ambiguous objectives into executable plans, synthesizes complex information into actionable recommendations, and can advance work with limited guidance—escalating appropriately on high-risk or cross-portfolio decisions—to ensure consistent implementation, visibility, accountability, and performance across UM operations.
Responsibilities:
Independently lead ambiguous or complex business initiatives with a high degree of ownership and accountability—assessing the problem, identifying required stakeholders, determining an appropriate path forward, and driving execution with limited guidance while exercising sound judgment on when to escalate high-risk or cross-portfolio decisions.
Utilize critical thinking and business judgment to evaluate operational challenges, identify root causes, assess risks and dependencies, and develop actionable recommendations for leadership.
Support and help operationalize strategies that advance operational performance, process standardization, governance effectiveness, and organizational priorities across UM.
Develop executive-level dashboards, scorecards, presentations, and status reports that clearly communicate program health, progress, risks, barriers, and outcomes.
Synthesize information from multiple sources to identify trends and opportunities, translating complex operational data into concise executive summaries with actionable insights, risks, and recommendations.
Maintain a strong working knowledge of UM operations, performance drivers, and key outcome metrics, staying closely connected to day-to-day operational realities to inform program priorities, recommendations, and decision support.
Partner with operational leaders to identify opportunities to improve efficiency, standardize processes, reduce administrative burden, and enhance organizational effectiveness.
Drive alignment across reporting processes, performance metrics, and operational reporting structures to improve consistency and establish a reliable source of truth.
Facilitate and coordinate cross-functional working sessions and governance forums involving Operations, Clinical, Analytics, Compliance, Medical Affairs, Workforce Management, Technology, Configuration, and other enterprise partners.
Coordinate stakeholder inputs and ensure information is accurately incorporated into executive reports, governance materials, operational plans, and program deliverables.
Lead assigned UM initiatives through the full project lifecycle, including intake, requirements gathering, project planning, execution, deployment, governance, and closure.
Translate broad leadership objectives into structured work plans, defined deliverables, measurable outcomes, and executable action plans.
Manage multiple concurrent initiatives and workstreams, ensuring alignment of scope, timelines, dependencies, resources, risks, and stakeholder expectations.
Establish and maintain structured intake, triage, and prioritization processes for operational, regulatory, strategic, and performance improvement requests.
Create and maintain centralized visibility mechanisms that clarify priorities, risks, decisions, action items, dependencies, and required leadership decisions.
Drive decision-making by presenting leadership with clear options, recommendations, risks, impacts, and implementation considerations.
Establish and maintain standardized processes, templates, governance artifacts, and program documentation—including project plans, RAID logs, decision logs, action item trackers, and executive communications—to support consistent execution and sustainability.
Proactively identify risks, barriers, dependencies, and downstream impacts; develop mitigation strategies and serve as a point of escalation to drive issue resolution, accountability, and closure of action items.
Challenge existing processes and identify opportunities to simplify workflows, eliminate inefficiencies, and improve governance, reporting, and portfolio management practices through standardization, automation, and continuous improvement.
Clearly communicate program status, business impacts, operational risks, and recommended solutions to stakeholders at all levels, including executive leadership.
Create and deliver best-practice guidance, training materials, and operational support resources to stakeholders, as applicable.
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
