We are seeking an experienced and highly organized Program Manager (Program Consultant) to support a statewide care coordination program. This role oversees training, compliance, auditing, and clinical consultation functions across a large network of Care Coordinators and partner organizations. The ideal candidate brings strong clinical judgment, exceptional communication skills, and the ability to manage complex regulatory requirements in a fast-paced, mission-driven environment.

Key Responsibilities
Training & Network Support
Deliver state-mandated training to the full statewide Care Coordination Organization (CCO) network.
Provide ongoing training on documentation standards, program requirements, HIP processes, and system updates to approximately 200 Care Coordinators.
Facilitate monthly technical assistance meetings with each CCO, plus ad-hoc trainings as needed.
Train supervisors on program expectations, compliance standards, and documentation quality.
Lead bi-monthly statewide training committee meetings and communicate follow-up actions to the network.

Clinical Consultation & Team Leadership
Provide clinical consultation to internal teams and external partners, including support for complex client cases.
Supervise internal Care Coordinators and offer ongoing clinical guidance.
Collaborate with behavioral health, physical health, and justice-involved support teams.
Serve as a clinical liaison for program-related inquiries, routing communications and resolving issues related to access, IT, billing, and member services.
Compliance, Auditing & Reporting
Conduct quarterly audits of 10% of engaged Health Homes charts (approximately 100 charts per quarter).
Lead all audit preparation and execution for TEAMonitor requirements.
Review quarterly eligibility files for each CCO, including manual verification of enrollee status.
Monitor caseloads, due diligence reports, documentation quality, engagement rates, and claims performance.
Manage Tier 2 exception approvals, tracking, and reporting.
Provide compliance feedback, education, and corrective action support (CAPS) to CCOs.
Respond to incident reports and coordinate required follow-up.
Program Operations & Administrative Oversight
Develop, update, and maintain program policies and procedures.
Monitor and manage the HIP inbox, providing timely assistance to network partners.
Upload and track consents, ensuring accuracy and compliance.
Communicate program updates, contract changes, and new processes to the entire network.
Support operational efficiency through proactive communication, problem-solving, and cross-team collaboration.

Qualifications
Bachelor’s or Master’s degree in Social Work, Nursing, Behavioral Health, Public Health, or a related field (Master’s preferred).
Clinical licensure (LICSW, LMHC, RN, etc.) strongly preferred.
3–5 years of experience in care coordination, managed care, behavioral health, or a related field.
Strong understanding of state-regulated care coordination models and compliance requirements.
Experience delivering training to large groups and supporting multi-site or statewide networks.
Excellent organizational skills with the ability to manage multiple deadlines and complex workflows.
Strong analytical skills with experience conducting audits and reviewing documentation.
Exceptional written and verbal communication skills.
Ability to work independently and collaboratively while exercising sound clinical judgment.




Equal Opportunity Employer / Disabled / Protected Veterans

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