Program Manager – and Improvement

Program Manager – Performance and Improvement
- Southwestern Health Resources

Southwestern Health Resources is looking for a highly skilled Program Manager.
Is that you?

Work Hours:

Full Time Days (8:00am-5:00pm) for 40 hrs/week (remote work allowed at manager’s discretion)

Department Highlights:

• Hybrid Position
• Gain a sense of accomplishment by contributing to a teamwork environment.
• Receive excellent mentorship, comprehensive training, and dedicated leadership resources.
• Contribute and work on a cross functional team

What You Will Do:

Performance Surveillance & Opportunity Identification
. Metric Monitoring:
Continuously monitor performance indicators, including clinical quality metrics (HEDIS/Star Ratings/ACO) or utilization and spend trends (readmissions, ED visits, inpatient days), to proactively identify performance drops or cost spikes.
. Performance Governance & Root-Cause Analysis:
Convene and facilitate targeted cross-functional work groups and performance taskforces, bringing together data analysts and clinical leaders to investigate anomalies and align on systemic operational barriers and solution planning.
.

Cross-Functional Collaboration:

Directly partner with operational execution teams, such as Care Management, Pharmacy, or Population Health, to present findings, map existing clinical programs against identified performance gaps, and drive cross-functional teams to roll out targeted interventions and performance improvement plans. 30%
Strategy, Process Improvement & Workflow Optimization
. Performance Roadmap & Annual Planning:
Lead the development and execution of a comprehensive, tailored annual action plan for each designated performance metric
. Continuous Process Improvement:
Partner with clinics and CIN stakeholders to design, implement, and scale sustainable clinical workflows that naturally capture quality metrics or prevent avoidable utilization at the point of care.
. Best Practice Spreading:
Identify high-performing clinics within the network, extract their successful operational behaviors (e.g., optimized documentation workflows), and build strategies to spread those practices across the CIN.
. EMR Optimization & Workflow Advocacy:
Collaborate with technical and clinical teams to optimize EMR configurations, ensuring that point-of-care alerts, clinical connectors, and documentation templates streamline provider workflows and drive accurate reporting outcomes. 40%
Clinic Education & Strategic Network Initiatives
. Clinical Network

Education:

Partner with Provider Relations team to translate complex metric goals into actionable, hands-on training and workflows for frontline clinic staff and physicians.
. Patient Outreach & Campaigns:
Design and deploy targeted patient outreach initiatives, preventative health screenings, and seasonal clinical campaigns to close true care gaps effectively.
. Payer Reconciliation & Data Integrity:
Act as the department's representative for seasonal payer reconciliation audits, ensuring that quality data, utilization metrics, and supplemental data files are accurately captured and reflected in final contract settlements.
. Senior Management Reporting:
Author high-level executive summaries, utilization/quality trend variations, and performance trajectory briefs for senior leadership to outline risks and financial opportunities. 30%

What You Need:

Education
Bachelor's Degree Healthcare Administration, Business Administration, Public Health, Nursing, or a related field Req
Master's Degree Healthcare Administration, Business Administration, or Public Health Pref
Experience
5 Years 5 years of progressive experience in value-based care, managed care, healthcare quality improvement, or…