Medical and Healthcare Economics Program Manager

Location Address:

Compensation Pay Range:

Summary:

Responsibilities:

The Medical Economics Program Manager is responsible for driving execution, oversight, and accountability across Medical Economics initiatives. This role serves as the central coordination point for all Med Econ workstreams-including Medical Cost Savings, Pharmacy, Network, Payment Integrity, Care Management (CM), and Utilization Management (UM).
Reporting to the Director of Medical Economics, this individual ensures initiatives are clearly defined, rigorously tracked, and delivering measurable financial and operational outcomes. The role blends program management, financial tracking, and cross-functional coordination to translate strategy into execution.

Some key responsibilities include:

• Manage governance and execution of Medical Economics workstreams across the health plan, ensuring alignment, accountability, and delivery of initiatives related to total cost of care, provider performance, value-based care, and Med Econ reporting
• Lead day-to-day management of Medical Economics initiatives across all major savings and performance domains
• Establish and manage structured forums (weekly workstream reviews, monthly executive updates, etc.)
• Partner with workstream owners (Clinical, Network, Pharmacy, Finance, Operations) to ensure alignment on goals, timelines, and deliverables
• Maintain and actively manage RAID logs (Risks, Assumptions, Issues, Dependencies) across all initiatives
• Ensure accountability through clear action tracking, ownership, and follow-ups
• Implement scalable program management best practices across Med Econ
• Develop executive-ready reporting on initiative status, financial impact, and key decisions required
• Translate complex data into clear narratives, highlighting performance vs. plan
• Support preparation of materials for CFO, CMO, and senior leadership reviews
• Ensure all initiatives have clearly defined workstreams, owners, milestones, and KPIs
• Own centralized tracking of all savings initiatives and reporting
• Standardize approach to baseline development, intervention measurement, and ROI tracking
• Identify risks, gaps, and underperformance early and escalate with recommended mitigation strategies
• Act as the connective tissue across departments contributing to Medical Economics outcomes
• Coordinate inputs from Clinical, Network, Pharmacy, Finance, and Operations teams
• Ensure dependencies are identified and managed across teams
• Facilitate decision-making by aligning stakeholders on priorities and trade-offs

Qualifications:

• Bachelor's degree in business, healthcare, finance, or related field or equivalent practical experience
• 4-8+ years of experience in healthcare, health insurance, consulting, finance, or related field
• Experience supporting or leading cross-functional initiatives, programs, or workstreams
• Demonstrated ability to manage multiple priorities in a fast-paced environment
• Experience developing executive-level materials and communicating with senior stakeholders
• Strong organizational, problem-solving, and attention-to-detail skills
• Strong analytical and financial acumen, with ability to understand and track savings initiatives

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness
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Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.