Strategic Program Manager, Medicaid P&L

Employment Type Full-time

Exempt or Non-Exempt Exempt

Job Summary

• Hybrid Work Environment - Must reside in Hawaii**

Pay Range: $68,000 - $133,000

Note: Individuals typically begin between the minimum to middle of the pay range

The Strategic Program Manager, Medicaid Financial Performance is responsible for strategic oversight, financial performance management, and operational analysis supporting Medicaid P&L objectives.

This position requires program execution with enterprise‑level financial stewardship, including budgeting, forecasting, cost driver analysis, and performance optimization. The role ensures that QUEST programs deliver measurable value, contractual compliance, and financial sustainability while advancing HMSA's Medicaid strategy.

Minimum Qualifications

• Bachelor's degree and six years of related experience in Medicaid/managed care, healthcare operations, program performance, finance, or analytics.
• Three years of experience leading complex projects and developing business recommendations.
• Strong analytical and project management skills; ability to communicate complex information clearly and concisely to leadership.
• Working knowledge of regulated program requirements and documentation standards.
• Good working knowledge of Microsoft Office applications to include Word, Excel, PowerPoint, and Outlook.

Duties And Responsibilities

• Financial Performance Management & Business Planning

• Leads program-level financial performance routines (budget tracking, variance drivers, and corrective action plans).

• Develops business cases and financial impact assessments for Medicaid initiatives.

• Supports forecast inputs through structured monitoring of operational and programmatic drivers.

• Coordinates with Finance, Actuarial, Provider Ops, Health Mgmt, Compliance, and IT to translate insights into action.

• Creates executive-ready dashboards, summaries, and decision materials.

• Performance Optimization Initiatives

• Designs and manages cross-functional initiatives that improve affordability, efficiency, and performance outcomes.

• Applies continuous improvement methods to streamline workflows, reduce administrative burden, and enhance program effectiveness.

• External / Contract Alignment Support

• Ensures initiatives and investments align with CMS/DHS/MQD requirements and QUEST priorities; supports documentation for audits/reviews as needed.

• Mentorship & Capability Building

• Mentors analysts/PM resources, reinforcing standards for documentation, analysis quality, and accountability.

• Other Duties/Functions

• Performs all other miscellaneous responsibilities and duties as assigned or directed.