Healthcare Programs Manager — Lead Cross-Functional Care

Molina Healthcare; San Francisco (CA); On-site; USD 84,000 - 164,000; Full time

Job summary

Molina Healthcare seeks an experienced healthcare services leader to guide program design, execution and evaluation while ensuring regulatory and contractual compliance. You will act as a subject matter expert across clinical operations and coordinate cross‑functional teams to deliver quality, cost‑effective member care.

Responsibilities include driving process improvements, communicating program goals, managing budgets and vendors, translating needs into BRDs and test plans, and developing

Qualifications

• 5+ years healthcare experience including clinical operations and 3+ years in utilization/care management or related areas.
• Active professional licensure as required by state contract and regulation; license must be active and unrestricted.
• Strong analytical and problem-solving abilities.
• Excellent organizational and time-management skills.
• Ability to work in a cross-functional professional environment.
• Experience with regulatory requirements and third-party regulations.
• Strong communication skills, both spoken and written.

Responsibilities

• Plan and execute healthcare services projects with cross-functional teams from design to completion.
• Communicate program goals and evaluation results to ensure protocol compliance.
• Oversee external vendors when engaged.
• Drive process improvement, change management and program management initiatives.
• Serve as SME to meet critical healthcare services needs.
• Translate customer needs into functional requirements.
• Conduct quality audits and implement related quality initiatives.
• Create BRDs, test plans, RTMs and training materials.

Skills

Analytical skills

Time management

Cross-functional work

Regulatory/compliance awareness

Verbal and written communication

MS Office / databases proficiency

Education

RN / LVN / LPN / APSW / CHES / LPC / LPCC / LMFT license

Tools

Microsoft Office

Job description

Molina Healthcare seeks an experienced healthcare services leader to guide program design, execution and evaluation while ensuring regulatory and contractual compliance. You will act as a subject matter expert across clinical operations and coordinate cross‑functional teams to deliver quality, cost‑effective member care.

Responsibilities include driving process improvements, communicating program goals, managing budgets and vendors, translating needs into BRDs and test plans, and developing