Clinical Content & Policy Program Manager

Presbyterian Healthcare Services

6d • $94,058 - $143,707 • Hybrid

About The Position

Build your Career. Make a Difference. Presbyterian is hiring a skilled Clinical Content & Policy Program Manager to join our team. The Clinical Content & Policy Program Manager is responsible for development, management, and oversight of clinical program documentation and healthcare policy interpretation across the health plan enterprise. This role serves as a strategic liaison between clinical operations, product, provider relations, and communications teams to ensure accurate, consistent, and regulatory-aligned clinical content. The position leads the creation and maintenance of provider-, employer-, and member-facing clinical content used to support organizational initiatives, program education, marketing materials, and external business communications. The role also interprets federal and state healthcare policy requirements and translates regulatory guidance into operational and clinical program language. This position requires strong healthcare operational knowledge, exceptional writing and communication skills, and the ability to synthesize complex clinical and regulatory information into clear, audience-appropriate content.

Requirements

• Bachelor’s degree in Nursing, Healthcare Administration, Public Health, Communications, or related field required.
• Minimum of 5 years of experience in healthcare, health plan operations, clinical program management, medical policy, healthcare communications, or related field.
• Experience developing clinical, operational, or healthcare regulatory documentation.
• Strong understanding of healthcare delivery systems, managed care, Medicare, Medicaid, and population health programs.
• Demonstrated ability to interpret and apply healthcare regulations and accreditation standards.
• Exceptional written, verbal, and organizational communication skills.
• Strong project management and cross-functional collaboration abilities.

Nice To Haves

• Master’s degree in Healthcare Administration (MHA), Public Health (MPH), Business Administration (MBA), Nursing, or related field preferred.
• Clinical licensure (RN, LCSW, or other healthcare licensure) preferred.
• Experience with NCQA, CMS, Medicaid, or Medicare Advantage regulatory frameworks preferred.
• Experience in healthcare communications, clinical strategy, or enterprise content development preferred.

Responsibilities

• Develop, maintain, and oversee enterprise clinical program descriptions and supporting documentation.
• Create and update documentation for care management, utilization management, population health, quality improvement, behavioral health, and other clinical programs.
• Ensure program documentation aligns with organizational goals, accreditation standards, and regulatory requirements.
• Collaborate with clinical and operational leaders to accurately represent workflows, interventions, and program outcomes.
• Develop provider-, employer-, and member-facing content that communicates clinical programs, health plan initiatives, and healthcare services.
• Create content for educational materials, program marketing collateral, implementation guides, external communications, and organizational publications.
• Support development of clinical narratives and content incorporated into organizational business materials, program overviews, and strategic communications.
• Ensure all clinical content is accurate, audience-appropriate, compliant, and aligned with organizational messaging standards.
• Maintain consistency of terminology, tone, and clinical messaging across enterprise materials.
• Monitor and interpret federal and state healthcare regulations, guidance, and policy updates impacting clinical programs.
• Analyze implications of regulatory changes and collaborate with operational leaders to support implementation.
• Translate complex clinical healthcare regulations into actionable operational and program language.
• Support organizational readiness related to CMS, state Medicaid, Medicare Advantage, NCQA, and other regulatory or accreditation requirements.
• Assist with policy review and documentation updates to maintain regulatory compliance.
• Partner with clinical operations, compliance, legal, quality, population health, communications, provider relations, and product teams to develop integrated content and program documentation.
• Facilitate stakeholder reviews and ensure alignment across departments.
• Serve as a subject matter resource for clinical program language, healthcare policy interpretation, and content standardization.
• Support enterprise initiatives requiring clinical documentation, operational narratives, or regulatory communication.

Benefits

• medical
• dental
• vision
• short-term and long-term disability
• group term life insurance
• other optional voluntary benefits
• Wellness Presbyterian's Employee Wellness rewards program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level