Demo

Value-Based Care Program Manager

MASC Medical Recruitment Firm
Los Angeles, CA Full Time
POSTED ON 3/21/2026
AVAILABLE BEFORE 4/21/2026
Value-Based Care Program Manager

Los Angeles

The Value-Based Care Program Manager is a key member of the leadership team. This role leads operational and strategic initiatives across our value-based care portfolio — driving performance, leading case management teams, and ensuring alignment between clinical excellence, quality outcomes, and payer expectations.

This position requires a balance of visionary leadership and tactical execution: you’ll build, refine, and scale case management-centric programs that deliver measurable results — while mentoring teams and collaborating with health plans, data teams, and executive leadership to advance our value-based mission.

Compensation & Benefits

  • $85,000 – $120,000 annually (DOE).
  • Medical, dental, and vision coverage; retirement; paid vacation; CME/licensure reimbursement.
  • Hybrid/remote flexibility with periodic in-person collaboration.


Responsibilities

  • 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

  • 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. (Managed a team of 5 or more)
  • 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.


#ZR

#MASC104

Salary : $85,000 - $120,000

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