Program Director, TechOps Core Systems

Molina Healthcare; Jacksonville (FL); Hybrid; USD 80,000 - 189,000; Full time

Job summary

A leading healthcare organization in Florida seeks a Program Director for TechOps Core Systems. The role entails overseeing performance and initiatives related to QNXT platform evolution, AI adoption, and claims adjudication. The ideal candidate will possess over 7 years of progressive experience in health-plan technology transformation, excellent communication skills, and a bachelor's degree. This position offers a hybrid work model and competitive compensation ranging from $80,412 to $188,164 annually.

Qualifications

• 7+ years of leadership in health-plan technology transformation.
• Experience with multi-vendor delivery.
• Certifications like PMP or SAFe are preferred.

Responsibilities

• Own the multi-year roadmap for Core Systems.
• Lead stakeholder engagement across IT and operations.
• Ensure compliance and operational metrics are met.

Skills

Program leadership

Communication skills

Cross-functional leadership

Education

Bachelor's degree in Business or Information Systems

Tools

QNXT

Lean Six Sigma

Job description

Job Summary

The Program Director, TechOps Core Systems provides department-level oversight for TechOps Core Systems performance and initiatives with emphasis on QNXT platform evolution, AI adoption, claims adjudication, provider/benefit configuration, and payments modernization. The role orchestrates cross‑functional planning and execution from strategy through stabilization, drives outcomes through governance forums and steers vendor partners to deliver resilient, compliant, and cost‑effective capabilities at scale. Success is measured by improved business outcomes (accuracy, timeliness, cost), predictable delivery, and production stability. The Program Director will oversee policy and procedure change management, drive operational excellence through performance metrics, and ensure adherence to regulatory and organizational standards.

Key Responsibilities

Portfolio Delivery & Governance

• Own the Core Systems multi‑year roadmap and annual portfolio plan; align initiatives to strategic objectives; maintain an integrated delivery calendar across QNXT, claims adjudication, configuration, and payments.
• Lead stakeholder engagement across IT, operations, and vendor partners.
• Chair/drive Core Systems leadership and governance forums (e.g., Steering Committees, Program Reviews, Monthly Operating Reviews), ensuring executive-ready deck preparation, synthesizing complex technical/operational topics and status reporting.

Risk, Compliance & Controls

• Maintain oversight of department compliance and operational metrics for monthly reporting to the HPS Compliance Committee.
• Work with the team to develop proactive action plans for compliance risk areas and fast escalation paths to the VP, Technical Operations and executive forums where required.
• Oversee compliance initiatives, including policy communication and annual review cycle.
• Build a culture of accountability, transparency, and continuous improvement across Molina and partner teams.

Knowledge, Skills & Abilities

• Expert program leadership in core administration platforms and adjacent domains (claims adjudication, provider/benefit configuration, payments).
• Excellent communication and influence skills with executives and cross‑functional leaders.

JOB QUALIFICATIONS

Required Education

• Bachelor's degree (Business, Information Systems, or related) or equivalent combination of education and experience

Required Experience

• 7+ years progressive program/portfolio leadership in payer core systems or large‑scale health‑plan technology transformation (including multi‑vendor delivery)

Preferred Experience

• Demonstrated delivery in at least two of: QNXT modernization, claims adjudication improvements, configuration/CIM programs, payments modernization

Preferred License, Certification, Association

• PMP and/or SAFe; Lean Six Sigma (Green/Black Belt) for operations improvement.

Working Conditions

• Hybrid/remote with periodic on‑site meetings; travel as required for vendor and leadership sessions.

Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $80,412 - $188,164 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.