Healthcare Programs Director: Strategy & Compliance

Molina Healthcare; United States; On-site; USD 85,000 - 120,000; Full time

Job summary

Molina Healthcare in the United States is seeking a senior leader to provide subject matter expertise and leadership to healthcare services. The role focuses on design, execution, evaluation of programs, and ensuring regulatory and internal standards compliance to deliver quality, cost-effective member care.

The position drives cross-functional collaboration, develops BRDs and test plans, and oversees vendor work when needed, with emphasis on process improvement and program management.

Qualifications

• At least 8 years of health care experience, including managed care and/or clinical operations.
• Clinical licensure and/or certification required only if mandated by state contract/regulation.
• Strong analytical and problem-solving skills.
• Strong organizational and time-management skills.

Responsibilities

• Manages one or more healthcare services clinical programs with staff and matrixed resources.
• Leads programs to meet business needs and requirements.
• Develops BRDs, test plans, RTMs, and training materials.
• Ensures compliance with regulatory standards and internal policies.
• Oversees external vendor work when applicable.
• Drives process improvement and program management across the enterprise.
• Communicates with stakeholders to translate needs into functional requirements.

Skills

Analytical skills

Time management

Cross-functional collaboration

Communication skills

MS Office

Education

RN or nursing license

LPN/LVN license

CHES certification

CCM/CPHM/CPHQ certification

Tools

Microsoft Office

Online portals & databases

Job description

Molina Healthcare in the United States is seeking a senior leader to provide subject matter expertise and leadership to healthcare services. The role focuses on design, execution, evaluation of programs, and ensuring regulatory and internal standards compliance to deliver quality, cost-effective member care.

The position drives cross-functional collaboration, develops BRDs and test plans, and oversees vendor work when needed, with emphasis on process improvement and program management.