Program Manager (Medicare Ops and Implementation)-REMOTE

Molina Healthcare; Oregon; Hybrid; USD 100,000 - 140,000; Full time

Job summary

Molina Healthcare is seeking a Program Manager to provide subject matter expertise and support for program management activities across Medicare line of business. The role involves governance, design, implementation, and continuous improvement of programs with cross-functional teams.

Responsibilities include driving KPIs, dashboards, and post-implementation reviews while ensuring compliant, well-documented processes and playbooks. Collaboration with legal, IT, and compliance is essential.

Qualifications

• 5+ years of progressive program or project management experience.
• Experience in healthcare/managed care environments.
• Strong data analysis capabilities.
• Budgeting and resource planning experience.
• Excellent communication and cross-functional collaboration.

Responsibilities

• Oversee design, implementation, and operations of assigned programs and services.
• Establish goals, scope, and success metrics for end-to-end program delivery.
• Develop governance frameworks ensuring compliant PM practices.
• Coordinate budgets and resources to meet objectives.
• Lead stakeholder engagement and governance meetings.
• Track performance with dashboards and KPIs.

Skills

Program management

Healthcare programs

Process improvement

Project management

Data analysis

Time management

Multitasking

Budgeting

Cross-functional collaboration

Communication

MS Office

Tools

Jira

Job description

Job Summary

Provides subject matter expertise and support for program management activities. Supports programmatic business needs across department and/or cross-functional areas, including programs design, implementation, administration, governance, workflow analysis, process improvements, vendor management, policy and playbook development and maintenance, best practices, resource allocations and special projects for the Medicare line of business.

Job Duties

• Oversees the design, implementation, delivery, and ongoing operations of respective business 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, key performance indicators (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.

JOB QUALIFICATIONS

REQUIRED QUALIFICATIONS :

• At least 5 years of progressive program and/or project management experience, with increasing levels of responsibility in a complex, matrixed organization, or equivalent combination of relevant education and experience.
• Experience leading medium-scale or multi-functional programs within healthcare, managed care, or a similar 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 simultaneously 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 of the organization.
• Advanced Microsoft Office suite (including Excel, PowerPoint, Project, and Visio), and applicable software programs proficiency.

Preferred Qualifications

• Project Management Professional (PMP), Six Sigma Green Belt and/or Black Belt certification.
• Health care/managed care experience
• Jira experience

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