Population Health Program Lead (Medicaid Compliance)

Molina Healthcare; Grand Rapids (MI); On-site; USD 66,000 - 130,000; Full time

Job summary

Molina Healthcare seeks a seasoned leader to ensure Michigan Medicaid population health programs comply with contracts and governance standards. You will manage CBO relationships, develop collateral, analyze data, and drive strategic decisions to improve health outcomes for Michigan residents.

You will collaborate with Legal, Compliance, and Information Security to uphold standards, track metrics, and shepherd program initiatives through lifecycle, ensuring timely, accurate reporting and

Qualifications

• At least 4 years of Program and/or Project management experience, or equivalent education and experience.
• Operational Process Improvement experience.
• Managed Care experience, preferably in a shared service, CoE or matrixed environment.
• Experience with Microsoft Project and Visio.
• Strong presentation and communication skills.

Responsibilities

• Designing and implementing population health programs to ensure Molina meets the needs of members and communities across Michigan, while maintaining compliance with State contracts.
• Responsible for ensuring well-documented policies, workflows, program controls, internal and third-party practices, playbooks and best practices for respective program.
• Collaborates with Legal, Compliance, and Information Security 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, as needed.
• At the direction of program leadership, supports portfolio management and/or initiative-specific change and project management.
• Collaborates with key stakeholders to support dissemination and adoption of program guardrails, processes, best practices and other collateral.
• Routinely reviews program collateral to ensure current and accurate reflection of business needs.
• Identifies opportunities/gaps and provides recommendations on program enhancements to respective leadership team.
• Responsible for creating business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations.
• Generates and distributes standard reports on schedule.

Skills

Project management

Process improvement

Managed care experience

Communication skills

Tools

Microsoft Project

Visio

Job description

Molina Healthcare seeks a seasoned leader to ensure Michigan Medicaid population health programs comply with contracts and governance standards. You will manage CBO relationships, develop collateral, analyze data, and drive strategic decisions to improve health outcomes for Michigan residents.

You will collaborate with Legal, Compliance, and Information Security to uphold standards, track metrics, and shepherd program initiatives through lifecycle, ensuring timely, accurate reporting and