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Program Manager, Medicaid - Remote

Blue Cross and Blue Shield of North Carolina


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       $79.8K to $101K per year is Indeed's estimated salary for program manager at Blue Cross and Blue Shield of North Carolina in Remote.

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Full Job Description

Blue Cross NC is improving healthcare for everyone. Doing that takes all of us, currently 4,500+ strong! Are you ready for a job that matters and a mission that is bigger?

The Program Manager position will lead the oversight and administration of the Healthy Opportunity Pilots (HOP) and NC Integrated Care for Kids (NCInCK) programs for Healthy Blue, Blue Cross NC's Medicaid program for North Carolina. The Healthy Opportunities Pilots are the nationís first comprehensive program to test evidence-based, non-medical interventions designed to reduce costs and improve the health of Medicaid beneficiaries. The pilots will provide up to $650 million in Medicaid funding for pilot services related to housing, food, transportation and interpersonal safety and toxic stress in three regions of the state. North Carolina Integrated Care for Kids is a new model aimed at improving the way children and families receive care and support services in Alamance, Durham, Granville, Orange, and Vance counties.

  • Strong candidates for this position will have a working knowledge of HOP and NCInCK priorities and goals
  • Coordination with the enterprise, Healthcare and the Blue Cross NC Foundation to ensure alignment across all segments
  • Direct and coordinate activities concerned with implementation and carrying out objectives of programs.
  • Establish and monitor performance metrics and goals for assigned programs, including process measures, outcomes measures, financial measures and methodologies for implementing programs. Document and present program results through operational reports, outcomes studies, presentations and publications.

Healthy Opportunity Pilot

As part of the Healthy Opportunity Pilot, you will service as a primary contact for three HOP Network Leads and provide oversight for Alliance partner's work. This work oversight will include:

  • Billing and Invoicing: Invoicing process that is more unwieldy than a claims process (everything from reconciling to processing to payment)
  • Data Analytics: Ensuring that a specific percentage of pilot participants align with regional demographics
  • Financial: Financial process oversight

You will also manage the relationship with Unite US (NCCARE360) for invoicing and referrals.


NCInCK work will include oversight of Alliance partner's execution of the following work:

  • Reporting: Quality improvement and operational excellence reporting on families served by NCInCK
  • Equity: Measure equity in care and outcomes, which require some specific strategy work and the subsequent execution
  • Health Assessment Screening
  • Behavioral Health: Determining collaboration opportunities to address behavioral health

Hiring Requirements

  • Bachelorís degree and 5 years of experience in program or project management in the area of program specialization.
  • In lieu of degree, 7 years of experience as stated above.
  • North Carolina residents strongly preferred.


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