Program Manager - Medi-caid / Medi-cal

Job Description

Job Description

Job Description : Medi-Cal Program Manager

Location : Nevada

Employment Type : Full-time

About the Role

We are seeking a Medi-Cal Program Manager to oversee the design, implementation, and management of Medi-Cal programs and initiatives across Nevada. This role will ensure compliance with state and federal regulations, improve service delivery, and drive performance outcomes in alignment with organizational goals. The Program Manager will collaborate with internal teams, healthcare providers, community partners, and regulatory agencies to ensure effective administration of Medi-Cal benefits and services.

Key Responsibilities

Oversee the planning, implementation, and monitoring of Medi-Cal programs within Nevada.

Ensure compliance with all Nevada Medicaid and federal Medi-Cal requirements , policies, and regulations.

Develop and manage program budgets, contracts, and reporting requirements.

Lead stakeholder engagement with healthcare providers, state agencies, and community-based organizations.

Analyze program data to identify trends, risks, and opportunities for improvement in service delivery and quality of care.

Collaborate with compliance and quality assurance teams to conduct audits, implement corrective actions, and maintain regulatory readiness.

Provide leadership and direction to program staff, fostering a culture of accountability, collaboration, and continuous improvement.

Prepare presentations, reports, and updates for executive leadership, state agencies, and external stakeholders.

Drive initiatives to improve member outcomes, provider satisfaction, and cost effectiveness of Medi-Cal services.

Qualifications

Education & Experience

Bachelor's degree in Healthcare Administration, Public Health, Business, or related field (Master's preferred).

Minimum of 5–7 years of program or project management experience in healthcare, with direct exposure to Medi-Cal, Medicaid, or managed care programs .

Strong knowledge of Nevada Medicaid policies and CMS regulations .

Experience with compliance, audits, and performance improvement in healthcare programs.

Proven ability to lead cross-functional teams and manage multiple projects simultaneously.

Skills & Competencies

Strong leadership and people management skills.

Excellent written and verbal communication abilities.

Data analysis and performance measurement expertise.

Ability to develop strong relationships with providers, regulators, and community partners.

Project management skills (PMP certification a plus).

Why Join Us

Opportunity to make a measurable impact in improving healthcare access and outcomes for Medi-Cal members in Nevada.

Collaborative work environment focused on innovation and compliance excellence.

Competitive compensation and benefits package.