Healthcare Programs Lead - Quality & Compliance

Molina Healthcare; Northern (KY); Hybrid; USD 66,000 - 143,000; Full time

Job summary

Molina Healthcare is seeking a subject matter expert to lead healthcare services programs and design, implement, and evaluate initiatives that align with regulatory and contract requirements. You will collaborate with cross-functional teams to deliver high-quality member care while driving cost-effective solutions.

The role emphasizes process improvement, program management, and quality audits to identify educational needs and service enhancements across the department.

Qualifications

• Five+ years in health care, incl. clinical operations and 3+ years in UM, care mgmt, transitions, behavioral health, or equivalent.
• Licensed/certified clinician required per state contract or regulation (RN/LVN/LPN/APS W/CHES/LPC/LPCC/LMFT).
• Strong analytical and problem-solving skills.

Responsibilities

• Lead internal healthcare services projects and programs from design to completion.
• Communicate program goals, evaluation, and support to ensure standardized processes.

Skills

Analytical skills

Time management

Verbal/written communication

Cross-functional teamwork

MS Office proficiency

Education

Clinical licensure or certification

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a subject matter expert to lead healthcare services programs and design, implement, and evaluate initiatives that align with regulatory and contract requirements. You will collaborate with cross-functional teams to deliver high-quality member care while driving cost-effective solutions.

The role emphasizes process improvement, program management, and quality audits to identify educational needs and service enhancements across the department.