Program Manager, Managed Care Operations

UCLA Health
is seeking a Program Manager to join the Managed Care Operations team.
Reporting to the Assistant Director, this role supports operational programs,
strategic initiatives, and compliance-driven projects across multiple
functional areas including Quality Management, Appeals & Grievances,
Credentialing, Member Services, Provider Relations, and Compliance.

You will
lead cross-functional initiatives, oversee process improvements, and serve as a
key liaison to internal and external stakeholders. The Program Manager will
manage timelines, resolve issues, and ensure operational activities align with
health plan requirements and departmental goals.

In this
role, you will:

• Manage and execute projects related to
  process improvement, performance monitoring, policy development, and
  regulatory implementation across multiple operational areas.
• Oversee day-to-day operational tasks,
  develop tools to improve efficiency, resolve issues, and monitor progress
  toward department performance targets.
• Coordinate reporting and data analysis
  to identify trends, ensure timely delivery of metrics, and support
  strategic planning and compliance efforts.
• Collaborate with system teams on CRM
  enhancements, UAT testing, training implementation, and business
  documentation (e.g., workflows, test plans, user guides).
• Lead departmental audits, mock reviews,
  and quality assurance programs while tracking risks and implementing
  corrective actions as needed.
• Drive internal communication strategies
  and manage project timelines, meeting agendas, and follow-through on
  action items.
• May conduct
  research and manage projects related to regulatory changes.

We're
seeking a results-driven leader with:

• Bachelor's degree in a related area, or
  equivalent experience required.
• Minimum 5 years of experience managing
  healthcare projects or programs (IPA, medical group, or health plan
  preferred).
• Strong background in managed care
  operations, project management, , and performance monitoring.
• Proficiency in Microsoft Office Suite,
  Visio, EPIC, Tapestry, and data tools like Tableau.
• Exceptional communication and
  presentation skills with the
  ability to lead cross-functional collaboration.
• Strong critical thinking,
  problem-solving, and organizational abilities.
• Ability to interpret complex
  regulations, improve workflows, and manage competing priorities with
  minimal supervision.
• Demonstrated
  skills in initiative, problem identification, resolution, and analytical
  skills.
• Experience
  coordinating UAT (user acceptance testing) efforts and supporting CRM
  optimization preferred.
• Demonstrated ability to influence
  stakeholders and manage change in a fast-paced, regulated environment.