Medicare Ops & Implementation Program Lead

Molina Healthcare, Inc.; United States; Remote; USD 90,000 - 130,000; Full time

Job summary

Molina Healthcare is seeking a seasoned program manager to provide subject matter expertise across Medicare program management activities, including governance design, workflow analysis, and process improvements. You will support design, implementation, administration, and reporting for cross-functional initiatives.

You will collaborate with legal, compliance, IT, and business leaders to ensure value realization, manage dashboards and KPIs, and maintain playbooks and BRDs.

Qualifications

• 5+ years of progressive program/project management experience in a complex, matrixed organization.
• Experience leading medium-scale or multi-functional programs within healthcare, managed care, or a regulated environment.
• Operational process improvement and change management experience.
• Project management experience/skills.
• Data analysis skills/experience.
• Strong organizational and time-management skills.
• Proven ability to manage multiple projects with competing priorities.
• Experience managing budgets and resource plans for business/strategic initiatives.
• Ability to work cross-collaboratively across a highly matrixed organization.
• Strong verbal/written/presentation communication skills, and ability to influence at all levels.

Responsibilities

• Oversees the design, implementation, delivery, and ongoing operations of respective program(s) and services.
• Supports end-to-end program delivery by establishing goals, scope, and success measures aligned with organizational priorities.
• Develops and maintains governance frameworks to ensure consistent, compliant, and effective program management practices.
• May oversee financial stewardship of program budgets - ensuring proper prioritization and alignment of resources to achieve desired outcomes.
• Partners with executive sponsors and functional leaders to ensure program objectives are met and value is realized across business units.
• Drives performance measurement and reporting, including dashboards, KPIs, and post-implementation reviews to track outcomes and identify opportunities for continuous improvement.
• Ensures well-documented policies, workflows, program controls, internal and third-party practices, playbooks and best practices for respective program(s).
• Collaborates with legal, compliance, information technology (IT), and other cross-functional teams to ensure governance standards are upheld.
• Tracks performance metrics and ensures value realization from deployed solutions.
• Coordinates recurring meetings to support governance framework and decision-making processes.
• Oversees portfolio management and/or initiative-specific programmatic changes and project management.
• Collaborates with key stakeholders to support dissemination and adoption of program guardrails, processes, best practices, etc.
• Routinely reviews program collateral to ensure current and accurate reflection of business needs.
• Promotes consistency in planning, communication, and execution across initiatives.
• Champions organizational change management by ensuring effective stakeholder engagement, communication, and adoption of new processes or technologies.
• Maintains and evolves program documentation, playbooks, and best practices to reflect current business needs and lessons learned.
• Identifies opportunities/gaps and provides recommendations on program enhancements to applicable leaders.
• Creates business requirements documents (BRDs), test plans, requirements traceability matrices, user training materials and other related documentation.
• Generates and distributes required business/programmatic reporting.
• Facilitates special functional/departmental projects.
• May provide specialized training and support to new and existing staff as needed.

Skills

Organizational skills

Time management

Data analysis

Communication skills

Cross-functional collaboration

Budget management

Project prioritization

Education

PMP certification

Six Sigma Green Belt/Black Belt

Tools

Jira

Microsoft Office

Visio

Project

Job description

Molina Healthcare is seeking a seasoned program manager to provide subject matter expertise across Medicare program management activities, including governance design, workflow analysis, and process improvements. You will support design, implementation, administration, and reporting for cross-functional initiatives.

You will collaborate with legal, compliance, IT, and business leaders to ensure value realization, manage dashboards and KPIs, and maintain playbooks and BRDs.