Program Director (MES)

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Acentra Health is looking for a Program Director to join our growing team.

Job Summary:

The Benefit Management Operations Manager and Program Director serves as the primary point of contact for operational issues related to the Wyoming Benefit Management System (WY-BMS). In this key leadership role, you will oversee complex healthcare program operations, ensuring services are executed effectively, on time, and within budget. This includes managing day-to-day operations, coordinating cross-functional teams, and delivering high-quality services that meet both client expectations and organizational standards.

You will be responsible for developing and enforcing operational policies and procedures, supervising staff, maintaining strong relationships with clients and stakeholders, and ensuring timely and accurate communication between external partners and the company. This role also includes monitoring operational performance, providing status updates to leadership, and ensuring compliance with all applicable Agency, State, and CMS guidance related to benefit and claims processing-such as claims intake, pricing, processing, reference data, and business operations.

The Benefit Management Operations Manager and Program Director must ensure that all operational staff supporting WY-BMS are sufficiently trained and equipped to deliver excellent service.

This position is based in the Cheyenne, Wyoming office and will report to MES Vice President

Responsibilities:

• Manage and coordinate healthcare programs, ensuring the successful delivery of services, projects, and deliverables on schedule and within budget.
• Monitor program performance metrics, quality performance, deliverables, and budgets to ensure compliance with contractual requirements and organizational goals.
• Identify and address operational challenges, leveraging problem-solving skills to deliver practical solutions.
• Maintain strong, successful relationships with clients and key stakeholders, serving as a primary point of contact for program-related communication.
• Collaborate with cross-functional teams, including clinical, technical, and administrative personnel, to ensure seamless program execution.
• Develop and implement methods and procedures to improve program efficiency and outcomes.
• Manage program risk by identifying potential issues, developing mitigation strategies, and ensuring readiness for program launch and day-to-day operations.
• Prepare status reports and updates for internal leadership and client stakeholders.
• Support strategic planning initiatives to align program activities with organizational objectives and contribute to growth and innovation.
• Provide operational oversight and guidance to team members responsible for specific program functions or phases.
• Collaborate with Business Development to support new business opportunities as requested.
• Coordinates, directs and/or manages program operations for WY-BMS and directly supervises the Claims Manager, the Call Center and Relations Manager, and the Technical Services Delivery Manager.
• Ensure all contractual SLAs for WY-BMS are in place, reported on timely, and met.
• Monitor staffing goals to ensure fiscal responsibilities.
• Work closely with development team to ensure system enhancements supports WY-BMS.
• Identifies trends in issues and data and makes recommendations related to improving client, provider, and member satisfaction and internal efficiencies.
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

Required Qualifications

• Bachelor's degree Or Equivalent experience in lieu of degree will be considered
• 10 years' experience in a project planning and delivery as related to role
• 10 years' experience in managerial and leadership role.
• Medicare, Medicaid, or healthcare verticals domain knowledge with claims processing knowledge and experience.
• Demonstrated abilities with Microsoft Project, SharePoint applications, MS Teams, Skype and knowledge of MS Project EV Metrics.
• Proven track record to meet and enforce deadlines, conduct research into technology issues and products, and to take initiative in the development and completion of projects.
• Demonstrated experience in leading and managing complex technical programs
• Demonstrated successful people management and presentation skills.
• Ability to exercise independent judgement in solving complex and unusual technical, administrative, and managerial problems
• Ability to meet and enforce deadlines, to conduct research into technology issues and products, and to take initiative in the development and completion of projects
• Strong problem-solving, analytical, and evaluate skills
• Travel up to 25%, program dependent.

Preferred Qualifications

• Certified Project Management Professional (PMP) preferred
• Master's Degree

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Compensation

The pay range for this position is listed below.

"Based on our compensation philosophy, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level."

Thank You!

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at Acentra.com/careers/

EEO AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.