Manager, Clinical Program Management – Vendor Performance

Role Overview

• Compile reporting related to the performance and continuous improvement of Utilization Management (UM), Care Management (CM) and vendor programs.
• Collaborate across clinical, operational and analytic teams for all lines of business to ensure compliant and high quality member centered outcomes.
• Support program monitoring, reporting, vendor performance management, and execution of internal operational improvements and vendor oversight for compliance requirements.
• Conduct research and assist with workflow assessments to support operational improvements.
• Ensure program compliance with regulatory, contractual, and audit expectations, including Utilization Management/Care Management standards.
• Facilitate recurring vendor meetings, prepare agendas, document updates, and drive follow‑up actions.
• Prepare summaries of program performance, risks, and operational recommendations for leadership.

Requirements

• Bachelor’s degree in healthcare administration, public health, social work or related field required.
• Master’s degree in nursing preferred.
• Clinical licensure such as Registered Nurse (RN), Licensed Practice Nurse (LPN), and/or Social Work (SW) preferred.
• Knowledge of Utilization Review Accreditation Commission (URAC) Utilization Management/Care Management standards preferred.
• Minimum seven (7) years' experience Utilization Management or Care Management OR applicable master’s with minimum five (5) years’ experience.
• Minimum two (2) years’ leadership experience (team, role, and/or project management).
• Minimum of two (2) years demonstrated experience in reporting or dashboarding for program management to track key performance indicators.
• Experience managing or working with external vendors preferred.
• Strong knowledge of Utilization Management or Care Management workflows, documentation standards, and care coordination processes.
• Demonstrated critical thinking and sound judgment.
• Ability to interpret performance data, identify trends, and develop actionable recommendations.
• Ability to lead requirements development and collaborate with data team to develop reporting and dashboarding for program monitoring.

Benefits

• Tuition reimbursement.
• Club Blue, a free, onsite gym to encourage exercise.
• Green Leaf Grill and Green Leaf Grill Express, onsite restaurants in Little Rock that promote healthy eating.
• Incentives for wellness education and exercise.