Maine Licensed Clinical Programs Director

Job Summary

A company is looking for a Director of Health Plan Clinical Programs.

Key Responsibilities

• Develop and implement new programs to improve population health and reduce costs
• Oversee care management operations, ensuring high-value support for members
• Drive results through data analysis, monitoring performance, and regulatory compliance

Required Qualifications

• Clinical background (RN, NP, PA, PharmD, or similar licensure)
• Bachelor's degree in a clinical field (Master's preferred)
• 10+ years of healthcare experience in managed care and related fields
• Demonstrated success in program design, implementation, and evaluation
• Deep knowledge of Medicare Advantage, CMS Stars, and regulatory requirements