WellSense Health Plan ยท 10 hours ago
Program Manager, Clinical Insights
United States
Full-time
Remote
Mid Level
$70K/yr - $100K/yr
3+ years expWellSense Health Plan is a growing regional health insurance company with a 25-year history of providing health insurance that works for our members. The Program Manager, Clinical Insights is responsible for implementing and managing programs aimed at improving health outcomes and financial performance through collaboration with various clinical stakeholder groups.
Hospital & Health Care
Responsibilities
Implement and manage member health promotion programs associated with NCQA Population Health Management standards, and general member health and wellness programs designed to improve health outcomes and reduce inappropriate utilization, including pilots and new program design interventions
Lead performance improvement projects associated with annual Performance Improvement budget and corporate goals, assembling stakeholders to design, execute, and monitor projects
Manage and drive execution on outbound campaigns and selective member outreach, partnering with Care Management teams and Quality
Key point of contact to engage with marketing on overall clinical, member facing information
Support centralization of active member outreach by various teams
Support program monitoring through the use of analytic dashboards and KPIs
Qualification
Required
Bachelor's degree or equivalent combination of education and relevant experience in a health plan setting required
3+ years of healthcare/managed care experience
3+ years in program management, healthcare operations, or other applicable work experience
Managed care experience in NCQA accreditation, care management, population health, or quality programs
Successful completion of pre-employment background check
Exceptional written and oral communication skills
Excellent organizational skills and attention to detail
Demonstrated ability to work independently and manage multiple complex projects simultaneously
Proactive, motivated, and a collaborative team player
Demonstrated ability to adapt quickly to changing priorities
Strong critical thinking, analytical, and problem-solving skills
Proficiency with MS tools including Word, Excel, PowerPoint, Visio and MS Project
Demonstrated ability of managing competing priorities as well as stakeholders with differing objectives/perspectives
Preferred
Master's degree in business or health related/public health field preferred
Benefits
Medical
Dental
Vision
Pharmacy
Merit increases
Flexible Spending Accounts
403(b) savings matches
Paid time off
Career advancement opportunities
Resources to support employee and family wellbeing
Company
WellSense Health Plan
A nonprofit health plan serving Medicare, Individual & Family, and Medicaid plan members in Massachusetts & New Hampshire.
1001-5000 employees
H1B Sponsorship
WellSense Health Plan has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (1)
2024 (8)
2023 (2)
2021 (2)
2020 (1)
Funding
Current Stage
Late StageLeadership Team
Heather Thiltgen
President & CEO
Diana Cruz
Chief Operating Officer
Company data provided by crunchbase