Lead Total Cost of Care Program Manager

Pay Range:

$102,300.00 - $163,700.00 

Please email [email protected] if you are a candidate seeking a reasonable accommodation for the application and/or interview process.

 

At BCBSRI, our greatest resource is our people. 

We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do—not just for our members, but for our employees as well.

We recognize that to do your best work, you have to be your best self. 
It’s why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees.

Our culture is one of belonging.
We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you’re at in the organization, you’re an integral part of our team and your input, thoughts, and ideas are valued.

Join others who value a workplace for all.
We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders. 

We’re dedicated to serving Rhode Islanders.
Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state—building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer.

 

Why this job matters:

Integral part of the TCOC team dedicated to managing the enterprise’s medical costs while continuously improving member outcomes, quality and experience. Works closely with the Director and other key stakeholders across the organization to provide strategic, analytical and execution leadership to achieve enterprise TCOC goals.

What you will do:

• Support the broader TCOC team with planning, sizing, and executing Total Cost of Care initiatives across key medical spend categories.
• Facilitate analyses of medical cost drivers, utilization patterns, and trend data to inform and prioritize medical cost management opportunities
• Synthesize complex data into clear, actionable insights for leadership, translating analytical findings into executive-ready narratives and recommendations.
• Partner with the broader TCOC team to quantify initiative opportunities through sizing analyses, including baseline development, target population identification, and financial impact estimation
• Track initiative status, financial impact, and key performance indicators, escalating issues as appropriate
• Partner with analytics and finance teams to track savings and monitor performance against targets.
• Support stakeholder engagement and follow-up actions across matrixed teams.
• Develop materials for governance forums, leadership updates, and working sessions.
• Identify opportunities to enhance analytical approaches, reporting, and tools supporting Total Cost of Care management.
• Stay informed of industry trends, best practices, and regulatory considerations impacting medical cost management.
• Perform other duties as assigned.

What you need to succeed:

• Bachelor’s degree in healthcare administration, business, finance, public health, analytics, or a related field.
• Seven to ten years of experience in healthcare, health plan operations, medical economics, consulting, or value-based care.
• Experience supporting or leading cross-functional initiatives with measurable financial or utilization impact.
• Strong analytical skills, including experience working with healthcare cost and utilization data.
• Advanced proficiency in Microsoft Excel, including pivot tables, complex formulas, and data analysis techniques.
• Ability to assess medical cost drivers and identify actionable opportunities
• Experience sizing initiatives, including estimating addressable population and financial impact
• Strong critical thinking and hypothesis-driven analysis
• Understanding of healthcare cost structures and utilization metrics
• Advanced Excel proficiency (pivot tables, lookups, scenario modeling, macros/automation)
• Ability to build and interpret financial models and forecasts
• Ability to manage multiple initiatives with competing priorities
• Strong attention to detail and accountability for outcomes
• Ability to distill complex analytical findings into clear, executive-level messaging
• Strong written and verbal communication skills
• Ability to work across matrixed teams and influence without direct authority
• Strong stakeholder management and follow-through

The extras:

• Master’s degree (MBA, MHA, MPH, or similar).
• Experience performing initiative sizing, cost modeling, or financial impact analyses.
• Experience with Excel macros, automation techniques, or large dataset manipulation.
• Familiarity with health plan data environments and reporting tools (e.g., SQL, Tableau, Power BI).

 

Location:
BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:

• In-office: onsite 5 days per week
• Hybrid: onsite 2-4 days per week
• Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia
   

Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today’s healthcare industry. BCBSRI is an equal opportunity employer.

The law requires an employer to post notices describing the Federal laws. Please visit  www.eeoc.gov/know-your-rights-workplace-discrimination-illegal to view the "Know Your Rights" poster.