Program Manager IV, Health Plan Accreditation

Sutter Health

Sacramento, CA

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JOB DETAILS

SALARY

$114,774.40–$172,161.60 Per Year

SKILLS

Analysis Skills, Business Administration, Business Plan, Corrective Action, Cross-Functional, Customer Experience, Dental Insurance, Documentation, Gap Analysis, Health Plan, Healthcare Providers, Interpersonal Skills, Maintain Compliance, Meeting Minutes, Microsoft Excel, Microsoft Office, Microsoft Outlook, Microsoft PowerPoint, Microsoft Project, Microsoft Visio, Microsoft Word, Monitor Regulations, National Committee for Quality Assurance (NCQA), Program Management Professional (PgMP), Project Management Software, Project Planning, Project/Program Management, Qualitative Research, Quality Management, Quantitative Analysis, Quantitative Research, Regulatory Compliance, Risk Analysis, Strategic Planning, Training/Teaching, Utilization Management

LOCATION

Sacramento, CA

POSTED

3 days ago

We are so glad you are interested in joining Sutter Health!

Organization:

Sutter Health Alliance - Valley

Position Overview:

The Program Manager IV is an experienced program management professional with demonstrated expertise in NCQA accreditation. This position leads Sutter Health Plan's NCQA accreditation strategy, with primary accountability for maintaining continuous survey readiness and successfully completing the triennial renewal process. The role drives cross-functional coordination across quality, utilization management, credentialing, population health, provider network, and other operational departments to ensure sustained compliance with NCQA standards and policies.

Core responsibilities include managing the accreditation project timeline and document submission process, conducting ongoing gap analyses against current NCQA standards, coordinating mock surveys and internal readiness assessments, and serving as the primary liaison with NCQA during survey activities. The Program Manager IV also leads the annual review and update of accreditation-related policies and procedures, delivers training to affected departments on standard revisions, oversees corrective action planning in response to survey findings or standard changes, and monitors regulatory developments—including DMHC requirements—that intersect with NCQA compliance obligations.

In addition to the core accreditation program, this position is responsible for Delegation Oversight of quality functions for the plan's dental and vision partners, supporting the Quality Improvement Committee, and leading the plan's annual Member Experience Analysis.

This role requires shared accountability for achieving accreditation outcomes, quality performance goals, and program-level service standards. The Program Manager IV demonstrates sound judgment in leveraging existing organizational resources, systems, and subject matter expertise to accomplish program objectives efficiently, and maintains clear accountability boundaries across cross-functional teams—escalating decisions and risks that impact scope through appropriate channels.

Maintains detailed program documentation, including project plans, status trackers, meeting minutes, and evidence files, in accordance with departmental standards and NCQA audit requirements; proactively identifies and communicates risks to project timelines. Must be able to assess and interpret quality and program performance data, translating findings into clear reports and written narratives suitable for operational, committee, and executive audiences.

Demonstrated proficiency in Microsoft Office Suite (Word, Excel, Visio, PowerPoint, Outlook, Teams) and project management applications (e.g., Microsoft Project or equivalent); ability to develop and maintain complex workplans, track deliverables, and produce polished documentation and executive-level presentations independently.

Job Description :

EDUCATION:

_Equivalent experience will be accepted in lieu of the required degree or diploma._

+ Bachelor's: Business Administration or related field

TYPICAL EXPERIENCE:

+ 8 years recent relevant experience.

SKILLS AND KNOWLEDGE:

+ Knowledge and understanding of strategic planning, including group facilitation and plan development.

+ Knowledge and understanding of business plan development, including qualitative and quantitative research and analysis.

+ Well-developed communication and interpersonal skills.

+ Ability to interact with a wide variety of internal and external customers, including patients, physicians, payors.

Job Shift:

Days

Schedule:

Full Time

Days of the Week:

Monday - Friday

Weekend Requirements:

None

Benefits:

Yes

Unions:

No

Position Status:

Exempt

Weekly Hours:

40

Employee Status:

Regular

Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.

Pay Range is $114,774.40 to $172,161.60 / annual salary

_The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health’s comprehensive total rewards program. Eligible positions also include a comprehensive benefits package._

About the Company

Sutter Health

Sutter Health has a long history in California. Some of our facilities have been providing care in the communities we serve for more than 100 years. Today, we’re proud to partner with more than 12,000 doctors to care for more than 3 million people.

We’re inspired by our Northern California community and work tirelessly to deliver top-rated, affordable healthcare. Doctors, hospitals, care teams and employees in the Sutter Health network are always looking for new, meaningful ways to care for you and your loved ones. We believe that every moment matters when it comes to helping you live a longer, healthier and happier life.

Our not-for-profit network delivers top-rated, personalized care in more than 100 Northern California communities. Recently ranked among the Top 15 Health Systems in the nation by Truven Health Analytics™, our team of more than 50,000 doctors, employees and volunteers partner to spread innovation, improve access to healthcare services and put our patients’ needs first—all to achieve the highest levels of quality, access and affordability.

COMPANY SIZE

10,000 employees or more

INDUSTRY

Healthcare Services

EMPLOYEE BENEFITS

Professional Development, 401K, Flexible Spending Accounts, Retirement / Pension Plans, Tuition Reimbursement, Life Insurance

FOUNDED

1921

WEBSITE

https://jobs.sutterhealth.org/