Clinical Support Sr Program Manager

Key Responsibilities

• DMH & DCC Program Operationalization & Expansion: Partner with Directors and leadership to shape, refine, and advance operational execution plans, scaling DMH and DCC programs from initial pilot clinics to national scale.
• Provider Integration & Clinic Readiness: Operationalize the integration of Primary Care Providers (PCPs) and Nurse Practitioners (NPs)—both internal staff and external partner networks—into dialysis centers. Establish clinic onboarding checklists, day-in-the-life workflows, and standard operating procedures (SOPs).
• Back-End Systems & Technology Infrastructure (Epic, OneView, CWOW): Partner closely with Product Management and IT to define, prioritize, and validate operational requirements for provider access, patient-to-provider relationship mapping, and clinical documentation flow.
• Access Governance & Data Continuity: Enforce operational access controls to maintain patient privacy standards, while ensuring clinical encounter notes and orders flow downstream seamlessly to CWOW, Epic, and repository systems (P8).
• Epic Transition Enablement: Support the migration of DMH/DCC clinical workflows and tools into the enterprise Epic platform, tracking build dependencies, operational action items, and trade-off recommendations for leadership.
• Care Management Billing & Revenue Cycle Infrastructure: Help establish, manage, and monitor the operational prerequisites and audit-ready tracking necessary to compliantly bill Medicare Fee-For-Service programs (CCM, PCM, TCM, CHEs).
• Cross-Functional Billing Alignment: Coordinate with Revenue Operations, Finance, Actuarial, and Compliance to establish billing capture protocols, resolve co-pay handling/waiver workflows, and assess FFS vs. risk-adjustment implications.
• Cross-Functional Governance & Operational SOPs: Serve as a central operational liaison across Legal, Regulatory, Compliance, Privacy (LCPR), Credentialing, and Clinical Risk to execute provider onboarding requirements, supervisory frameworks, and risk mitigations.
• Lifecycle Management & Change Enablement: Develop, document, and maintain SOPs for provider lifecycle events (credentialing verification, supervising physician links, provider offboarding, patient reassignment) and partner with clinical training teams on field job aids.
• Program Monitoring, Leadership Support & Continuous Improvement: Track and analyze operational metrics, enrollment figures, provider utilization, clinical documentation timeliness, and process adherence to provide regular visibility to leadership.
• Leadership Support & Thought Partnership: Partner with Directors and the Ops VP to draft executive summaries, synthesize operational data, prepare risk rundowns, and formulate options/trade-offs for leadership forums (Steering Committees, COO Reviews, Summit presentations).
• Process Optimization: Proactively identify workflow bottlenecks, escalate operational risks, and execute iterative process enhancements to support scalable growth.

Qualifications & Experience

• Education: Bachelor’s degree ideally in one of the following categories: Healthcare Administration, Business, Public Health, or related field required.
• Experience: 5–7+ years of progressive experience in healthcare operations, clinical program management, health systems consulting, or healthcare technology implementation.
• Value-Based & Primary Care Knowledge: Proven understanding of value-based care (VBC) models, integrated care coordination, and Medicare care management programs (CCM, PCM, TCM, CHEs).
• EHR & Technical Literacy: Demonstrated experience working with EHR/EMR platforms (Epic, CWOW, OneView, or equivalent clinical systems) and collaborating with technical product teams to operationalize clinical workflows.
• Strategic Problem Solving: Strong structured problem-solving skills with the ability to navigate ambiguous environments, translate strategic concepts into tactical operational workflows, and evaluate complex trade-offs.
• Cross-Functional Leadership: Demonstrated track record of building alignment across diverse internal and external stakeholders, including physicians, clinical risk, legal/compliance, engineering, and field leadership.
• Process Engineering & SOP Development: Expertise in designing scalable workflows, drafting clear standard operating procedures, and establishing operational governance frameworks.
• Communication & Executive Presentation: Excellent written and verbal communication skills; adept at synthesizing complex operational data into concise presentations for senior leadership.
• Appetite for Ambiguity: Effective at self-starting on occasion; desire to take ownership over workstreams and exercise own judgement to make improvements where you see opportunity.