Value-Based Care Program Manager
Not Disclosed•Full-TimeHybrid
location_on2450, Camino del Rio North, San Diego, San Diego County, California, 92108, United States
About the Role
The Value-Based Care Program Manager is a pivotal leader within our organization, bridging the gap between clinical excellence, quality outcomes, and payer expectations. This position is designed for a visionary leader who can balance strategic oversight with tactical execution to drive performance across our value-based care portfolio.
In this role, you will build, refine, and scale case management-centric programs that deliver measurable results. You will serve as the primary operational liaison to health plans, representing the company in performance-improvement discussions while collaborating with data teams and executive leadership to advance our mission. The day-to-day involves mentoring a multidisciplinary team, designing scalable workflows, and translating complex analytics into actionable strategies for high-risk populations and transitional care initiatives.
Work location
Work model: Hybrid
2450, Camino del Rio North, San Diego, San Diego County, California, 92108, United States
San Diego, California
Key Responsibilities
- check_circleDirect, coach, and mentor a multidisciplinary team to ensure excellence in care delivery
- check_circleManage quality, utilization, and cost metrics across multiple payer contracts and lead improvement initiatives
- check_circleDesign scalable workflows, standard operating procedures, and technology integrations to enhance care coordination
- check_circleServe as primary operational liaison to health plans and represent the company in performance discussions
- check_circlePartner with analytics to translate insights into action for HEDIS, TCM, ECM, and STAR measures
- check_circleDrive adoption of new initiatives, training, and policy updates across case management and quality teams
- check_circleProvide executive-level reporting, dashboard interpretation, and performance summaries to support leadership
- check_circleLead development and execution of case management and wrap-around programs for high-risk populations
Requirements
- verifiedBachelor's degree in Nursing, Social Work, Public Health, or Healthcare Administration (Master's preferred)
- verified5+ years in healthcare management, including at least 3 years leading case management or population-health teams
- verifiedStrong background in value-based care, risk adjustment, or health plan collaboration
- verifiedExpertise in quality frameworks (HEDIS, NCQA, DHCS, CMS) and population health reporting
- verifiedDemonstrated success building or scaling care management programs within Medi-Cal or Medicare settings
- verifiedPreferred Certifications: RN, LCSW, Case Management, or CCM
Nice to Have
Master's degree. Preferred certifications include RN, LCSW, Case Management, or CCM.
Benefits & Perks
check_circleMedical, dental, and vision coveragecheck_circleRetirement plancheck_circlePaid vacationcheck_circleCME and licensure reimbursementcheck_circleHybrid/remote flexibility with periodic in-person collaboration
Similar Job Opportunities
Skills, education and keywords
Skills: Hedis, Ncqa, DHCS, CMS, RN, LCSW, CCM, Case Management, Value-Based Care, Risk Adjustment.
Education: Bachelor's degree in Nursing, Social Work, Public Health, or Healthcare Administration required; Master's degree preferred.
Frequently asked questions about Value-Based Care Program Manager at MASC Medical Recruitment Firm
What does a Value-Based Care Program Manager at MASC Medical Recruitment Firm do?expand_more
In this Value-Based Care Program Manager at MASC Medical Recruitment Firm role, you will direct, coach, and mentor a multidisciplinary team to ensure excellence in care delivery; manage quality, utilization, and cost metrics across multiple payer contracts and lead improvement initiatives; design scalable workflows, standard operating procedures, and technology integrations to enhance care coordination; and serve as primary operational liaison to health plans and represent the company in performance discussions.
What are the requirements for this Value-Based Care Program Manager role?expand_more
To qualify for the Value-Based Care Program Manager at MASC Medical Recruitment Firm position, applicants should have: 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; Strong background in value-based care, risk adjustment, or health plan collaboration; Expertise in quality frameworks (HEDIS, NCQA, DHCS, CMS) and population health reporting; Demonstrated success building or scaling care management programs within Medi-Cal or Medicare settings; and Preferred Certifications: RN, LCSW, Case Management, or CCM.
Where is the Value-Based Care Program Manager role at MASC Medical Recruitment Firm located?expand_more
Value-Based Care Program Manager at MASC Medical Recruitment Firm is based in 2450, Camino del Rio North, San Diego, San Diego County, California, 92108, United States. This is a hybrid role.
Is this Value-Based Care Program Manager job remote, hybrid, or on-site?expand_more
MASC Medical Recruitment Firm has listed this Value-Based Care Program Manager role as hybrid.
How much experience is required for this Value-Based Care Program Manager role?expand_more
Value-Based Care Program Manager at MASC Medical Recruitment Firm typically requires 5+ years of relevant experience at the senior level.
What skills do you need for the Value-Based Care Program Manager role at MASC Medical Recruitment Firm?expand_more
Key skills for Value-Based Care Program Manager at MASC Medical Recruitment Firm include Hedis; Ncqa; DHCS; CMS; RN; LCSW; CCM; and Case Management.
What education is required for Value-Based Care Program Manager at MASC Medical Recruitment Firm?expand_more
Educational requirements for this role: Bachelor's degree in Nursing, Social Work, Public Health, or Healthcare Administration required; and Master's degree preferred.
What category does the Value-Based Care Program Manager role belong to?expand_more
Value-Based Care Program Manager at MASC Medical Recruitment Firm is part of the healthcare & nursing job category on Recrutus.
About MASC Medical Recruitment Firm
MASC Medical Recruitment Firm operates as a comprehensive healthcare staffing agency based in Fort Lauderdale, Florida, with additional operations in Houston, Texas. The organization specializes in connecting medical professionals with healthcare providers and organizations across the nation. Its operational model emphasizes a proactive and efficient approach supported by established resources and strategic relationships within the industry.
The firm offers tailored staffing solutions for a diverse range of medical roles, including physicians, mid-level providers, dentists, allied health personnel, and executives. Recognized for its effectiveness in physician recruitment, MASC Medical serves both individual practitioners and healthcare institutions seeking to fill critical positions. The company maintains a nationwide footprint while anchoring its primary operations in the Florida market, facilitating connections between talent and employers throughout the United States healthcare sector.
Browse more roles: All MASC Medical Recruitment Firm jobs, healthcare & nursing jobs on Recrutus.