Healthcare Program Manager (Only W2)

A large Healthcare organization is seeking a Program Manager to lead complex- multi-stakeholder initiatives within healthcare insurance and provider of eco-systems. This role is responsible for managing endtoend projects involving medical and pharmacy claims data, costofcare analysis, and enterprise data integration. The ideal candidates must have a PMP background and a particular focus on managing data integrations between medical and/or pharmacy claim based solutions.

Key Responsibilities Project Leadership & Execution
Within the PMP domain - someone who understands project financials & project ROI is critical as they have very rigorous expectation around managing project finances & delivering measurable benefits from their projects.

• Lead crossfunctional projects from initiation through delivery, ensuring alignment with strategic business objectives.
• Develop detailed project plans, schedules, risk logs, and communications in accordance with PMI/PMP standards.
• Facilitate collaboration across clinical, actuarial, analytics, IT, pharmacy, and business operations teams.
• Drive decision-making and project momentum in highly regulated, fastpaced environments.

Financial Management & ROI Accountability

• Create and manage comprehensive project budgets, forecasts, and financial reports.
• Evaluate business cases, quantify potential savings, and monitor benefit realization throughout the project lifecycle.
• Ensure each project delivers measurable value, including medical cost reduction, operational efficiencies, and improved care outcomes.
• Present financial results to senior leadership with clear justification of ROI and key drivers.

Claims Data & Integration Expertise

• Oversee initiatives involving the integration of medical and pharmacy claims across multiple systems and vendors.
• Coordinate data mapping, ETL workflows, data quality validation, and technical implementation with IT teams.
• Work with analytics teams to interpret claims trends, utilization patterns, and cost drivers.
• Support development of dashboards and reporting to track financial impact and clinical outcomes.

Healthcare & Industry Experience

• Apply deep knowledge of health plan, PBM, provider, and care management environments.
• Understand medical cost methodology, benefit structures, reimbursement models, and care delivery workflows.
• Partner with medical economics, underwriting, actuarial, and clinical partners to identify costofcare opportunities.

Stakeholder Management

• Communicate complex information to diverse technical and nontechnical stakeholders.
• Build trust and influence across executives, operational leads, IT teams, providers, and external vendors.
• Manage vendor relationships and contracts related to data platforms, integration partners, or analytics solutions.