UnitedHealthcare · 15 hours ago
CHIP Program Manager - Remote in Pennsylvania
United States
Full-time
Remote
Mid, Senior Level
$92K/yr - $164K/yr
3+ years expUnitedHealthcare is focused on simplifying the health care experience and creating healthier communities. The CHIP Program Manager is responsible for leading quality management, regulatory compliance, and operational oversight for the CHIP program, ensuring alignment with state and federal requirements while collaborating across teams to enhance program effectiveness and member experience.
FitnessHealth CareWellness
Responsibilities
Oversees the implementation of plan quality management components, including quality management committee project management and governance structure
Proactively manages and responds to rapidly changing state requirements and environments- has done presentations and interacted with state partners
Collaborates across business segments to attain or maintain the plan's compliance with NCQA accreditation standards and contractual requirements as they apply to the quality management program
Develops and maintains positive relationships with the state External Quality Review Organization (EQRO) within the scope of the quality management program
Submits reports and is experienced with excel, word, PPT and has some knowledge of manipulating quality data to meet state reporting. (SQL)- HEDIS background knowledge
Understand operational components of a health plan such as enrollment, claims, member services, network and vendor relations
Preferred experience in vendor relations and setting up contracts
Stakeholder and government relations: Serve one of the main liaison to Bureau of CHIP and represent the organization in State facing venues. Help to effectively communicate State expectations and directives to internal team members
Regulatory and policy oversight: Monitor state and federal regulations, ensure compliance, and ensure implementation of policy changes impacting the CHIP Program (in partnership with COPA and Compliance leads). This includes ensuring submission of required reports accurately and on time
Quality and performance: Work with internal quality management teams on performance improvement programs and serve as the contact for quality metrics like HEDIS and CAHPS for the CHIP membership
Program and operational management: Oversee program administration, and support cross-functional collaboration (Lead by Compliance and COPA)) to ensure program goals and State expectations are met
Member and partner communication: Serve as escalation point for member materials review and approval challenges including those requiring direct outreach and escalation to State contacts. Manage external communications with partners and legislative offices
Qualification
Required
Bachelor's degree in a business or healthcare related field
2+ years demonstrated Management experience of a team or projects and responsibility for performance management
1+ years of Quality improvement or operations experience within a health plan
Demonstrated experience with project management
Experienced professional who has experience doing presentations, leading projects and engaging with external regulatory agency partners
Experience working with senior leadership team
Reside within the state of Pennsylvania
Preferred
Experience with writing reports on outcomes of projects and maintaining project plans
Clinical knowledge
HEDIS knowledge
Proven ability to run data queries and manipulate clinical data or operational reports
Proven ability to make independent decisions
Demonstrated change management experience and skills
All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Benefits
Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution
Company
UnitedHealthcare
UnitedHealthcare helps people live healthier lives by simplifying the health care experience.
10001+ employees
H1B Sponsorship
UnitedHealthcare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (48)
2024 (26)
2023 (45)
2022 (61)
2021 (60)
2020 (68)
Funding
Current Stage
Late StageLeadership Team
Beth Soberg
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Bobby Gregoire
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