Program Manager, Healthcare Services - Clinical Analytics/Pega/CCA - Remote

Molina Talent Acquisition; United States; Teletrabalho; USD 90 000 - 120 000; Tempo integral

Resumo da oferta

Molina Healthcare is seeking a Senior Manager to lead the alignment and implementation of enterprise healthcare services strategies across health plans. You will act as a liaison between enterprise and market teams, promote consistency in program implementation, and ensure regulatory and contractual priorities are reflected in execution.

The role requires collaboration with clinical, operational, analytics, and compliance teams to drive successful initiatives and continuous improvement,

Qualificações

• Minimum 5 years in health care with clinical operations experience.
• At least 3 years in utilization management, care management, care transitions, behavioral health, or related fields.
• Strong analytical and problem-solving skills.
• Excellent organizational and time-management abilities.
• Experience working within state, federal, and third-party regulations.
• Strong verbal and written communication skills.
• Proficient with MS Office and online portals/databases.

Responsabilidades

• Collaborate with enterprise and market stakeholders to plan, implement, and sustain healthcare services initiatives.
• Serve as a communication conduit between enterprise teams and health plans, facilitating feedback and issue resolution.
• Identify barriers and risks, support governance, and monitor action plans for process improvements.
• Provide consultation on enterprise programs, regulatory requirements, and best practices to health plans.
• Coordinate cross-functional collaboration to ensure successful implementation of initiatives.
• Lead or support change management activities including stakeholder engagement and adoption strategies.
• Monitor progress, report risks and dependencies to leadership, and recommend actions.
• Gather business requirements and document operational needs for new processes, tools, and reporting capabilities.
• Develop and maintain project documents, execution guides, and executive summaries for stakeholder engagement.
• Support market readiness through training and ongoing operational support.
• Analyze market feedback and performance trends to drive continuous improvement.

Conhecimentos

Analytical skills

Time management

Organizational skills

Cross-functional collaboration

Regulatory knowledge

Communication skills

MS Office proficiency

Formação académica

RN or equivalent licensure

Ferramentas

Microsoft Office

Descrição da oferta de emprego

***Remote and must live in the United States***

JOB DESCRIPTION

Job Summary

Provides subject matter expertise and leadership to support the alignment and implementation of enterprise healthcare services strategies across health plans. Serves as a liaison between enterprise and market teams, facilitating communication, identifying operational risks and opportunities, supporting change management efforts, and promoting consistency in program implementation. Ensures awareness of regulatory, contractual, and organizational priorities while contributing to the successful execution of enterprise initiatives that improve member outcomes and operational performance.

Essential Job Duties

• Collaborates with enterprise and market stakeholders to support the planning, implementation, and sustainment of healthcare services initiatives, ensuring alignment with organizational goals and market needs.
• Serves as a key communication conduit between enterprise teams and health plans, facilitating two-way feedback, issue resolution, and information sharing.
• Supports governance and oversight activities by identifying implementation barriers, operational risks, and opportunities for process improvement, while partnering with stakeholders to develop and monitor action plans.
• Provides consultation and operational guidance to health plans regarding enterprise programs, strategic initiatives, regulatory requirements, and best practices.
• Facilitate cross-functional collaboration among clinical, operational, compliance, analytics, and other business partners to drive successful implementation of initiatives.
• Leads or supports organizational change management efforts, including stakeholder engagement, communication planning, and adoption strategies.
• Monitors initiative progress, evaluates outcomes, and communicates status, risks, dependencies, and recommendations to leadership and key stakeholders.
• Partners with enterprise teams and health plans to gather business requirements, document operational needs, and support implementation planning for new processes, tools, programs, and reporting capabilities.
• Develops and maintains project documentation, communication materials, implementation guides, executive summaries and other resources to support stakeholder engagement and operational execution.
• Supports market readiness and adoption of enterprise initiatives through training coordination, facilitation of workgroups, and ongoing operational support.
• Analyzes market feedback, performance trends, and emerging issues to inform enterprise decision-making and continuous improvement efforts.

Required Qualifications

• At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of the following areas: utilization management, care management, care transitions, behavioral health, or equivalent combination of relevant education and experience.
• Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC) or Licensed Marriage and Family Therapist (LMFT). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
• Strong analytical and problem-solving skills.
• Strong organizational and time-management skills.
• Ability to work in a cross-functional, professional environment.
• Experience working within applicable state, federal, and third-party regulations.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.

Preferred Qualifications

• Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM),Certified Professional in Healthcare Quality (CPHQ), or other health care or management certification.
• Project Management Professional (PMP), Lean Six Sigma, or other project management/process improvement certification preferred.
• Leadership experience.
• Medicaid/Medicare population experience.
  

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V