Program Manager IV, Disease Management

Sutter Health•Sacramento, CA

About The Position

The Program Manager IV is an experienced program management professional with expertise in delegated disease management and oversight of assigned population health programs. This position is responsible for managing Sutter Health Plan's portfolio of delegated disease management programs across multiple vendor partners, with accountability for program performance, member engagement, and regulatory/accreditation compliance. Covered programs include, but are not limited to, Asthma, Diabetes, Diabetes Prevention Program, Obesity, Prenatal and High-Risk Maternity, and the Doula Care Program. Core responsibilities include tracking and monitoring member participation across all programs, reviewing and evaluating vendor-submitted reporting for accuracy and completeness, and ensuring that program deliverables meet contractual and regulatory requirements. The Program Manager IV also develops professional program performance reports for internal and client audiences, conducts ongoing evaluations of program effectiveness, and identifies opportunities to improve vendor performance and member outcomes. This role drives cross-functional collaboration with quality, population health, clinical, and operational departments to ensure delegated programs align with the health plan's quality improvement strategy and NCQA accreditation standards. Shared accountability includes achieving quality performance goals, program growth objectives, and service and financial performance targets across the delegated disease management portfolio.

Requirements

8 years recent relevant experience
3 years of direct vendor management experience
3 years of program management experience, either in a managed care or health plan setting is highly desired
Demonstrated proficiency in Microsoft Office Suite (Word, Excel, Visio, PowerPoint, Outlook, Teams)
Demonstrated proficiency in project management applications (e.g., Microsoft Project or equivalent)
Ability to develop and maintain complex workplans, track deliverables, and produce polished documentation and executive-level presentations independently is highly desired
Knowledge and understanding of strategic planning, including group facilitation and plan development
Knowledge and understanding of business plan development, including qualitative and quantitative research and analysis
Well-developed communication and interpersonal skills
Ability to interact with a wide variety of internal and external customers, including patients, physicians, payors

Nice To Haves

MPH desired
Program Management Professional (PgMP) certification strongly desired

Responsibilities

Managing Sutter Health Plan's portfolio of delegated disease management programs across multiple vendor partners.
Accountability for program performance, member engagement, and regulatory/accreditation compliance.
Tracking and monitoring member participation across all programs.
Reviewing and evaluating vendor-submitted reporting for accuracy and completeness.
Ensuring program deliverables meet contractual and regulatory requirements.
Developing professional program performance reports for internal and client audiences.
Conducting ongoing evaluations of program effectiveness.
Identifying opportunities to improve vendor performance and member outcomes.
Driving cross-functional collaboration with quality, population health, clinical, and operational departments.
Achieving quality performance goals, program growth objectives, and service and financial performance targets.