Job Description

Value-Based Care Program Manager

San Diego (Hybrid)

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.
  

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