Program Manager -Payment Integrity/Prepayment Solutions (Remote)

Lensa; Bellevue (NE); Remote; USD 77,000 - 156,000; Full time

Job summary

An established industry player is seeking a dynamic Program Manager to lead Payment Integrity and Prepayment Solutions. This exciting remote role involves overseeing projects from inception to delivery, collaborating with cross-functional teams, and ensuring effective vendor engagement. The ideal candidate will possess strong project management skills, a background in healthcare, and a passion for process improvement. Join a forward-thinking organization that values innovation and excellence, and take your career to the next level while making a significant impact in the healthcare sector.

Qualifications

• 3-5 years of Program and/or Project management experience.
• Excellent presentation and communication skills.
• Experience with Operational Process Improvement.

Responsibilities

• Plans and directs schedules as well as project budgets.
• Monitors the project from inception through delivery.
• Leads and manages team in planning and executing business programs.

Skills

Project Management

Agile

Communication Skills

Healthcare Experience

Operational Process Improvement

Data Analysis

Vendor Management

Stakeholder Engagement

Education

Bachelor's Degree

Graduate Degree

Tools

Microsoft Project

Visio

Jira

PowerPoint

Excel

Job description

Program Manager - Payment Integrity/Prepayment Solutions (Remote)

Lensa is the leading career site for job seekers at every stage of their career. Our client, Molina Healthcare, is seeking professionals. Apply via Lensa today!

Molina Healthcare is hiring for a Program Manager – Payment Integrity/Prepayment Solutions Implementation. This role is remote and can be worked from states we are focused on hiring in.

Highly Qualified Candidates Will Have The Following Experience:

• Knowledge of claims / claims processing.
• Experience working within Payment Integrity and/or Prepayment solutions.
• Project Management, and/or Technical Project Management.
• Above average to expert level in Agile, Jira, PowerPoint, Excel.
• Understanding of who claims vendors are and what they do. Experience engaging vendors and ensuring the technologies are being implemented.
• Coding experience a plus!
• Familiar with QNXT is a plus.

Job Summary: Responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May engage and oversee the work of external vendors. Assigns, directs, and monitors system analysis and program staff. These positions' primary focus is project/program management.

Job Duties:

• Active collaborator with people responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion.
• Plans and directs schedules as well as project budgets.
• Monitors the project from inception through delivery.
• May engage and oversee the work of external vendors.
• Focuses on process improvement, organizational change management, program management, and other processes relative to the business.
• Leads and manages team in planning and executing business programs.
• Serves as the subject matter expert in the functional area and leads programs to meet critical needs.
• Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements. Delivers the appropriate artifacts as needed.
• Works with operational leaders within the business to provide recommendations on opportunities for process improvements.
• Creates business requirements documents, test plans, requirements traceability matrix, user training materials, and other related documentation.
• Generates and distributes standard reports on schedule.
• Possible travel up to twice per year.

Job Qualifications:

Required Education: Combination of education and experience or Bachelor's Degree.

Preferred Education: Combination of education and experience or Graduate Degree.

Required Experience/Knowledge, Skills & Abilities:

• 3-5 years of Program and/or Project management experience.
• Operational Process Improvement experience.
• Healthcare experience.
• Experience with Microsoft Project and Visio.
• Excellent presentation and communication skills.
• Experience partnering with different levels of leadership across the organization.

Preferred Experience:

• 5-7 years of Program and/or Project management experience.
• Managed Care experience.
• Experience working in a cross-functional highly matrixed organization.

Preferred License, Certification, Association:

• PMP, Six Sigma Green Belt, Six Sigma Black Belt Certification, and/or comparable coursework desired.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

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

Same Posting Description for Internal and External Candidates

Key Words: Project Management, Business Owner, Healthcare, Data, Provider, Provider Liaison, Claims, Provider Claims, Stakeholder Engagement, Regulatory Compliance, Risk Management, Process Improvement, Data Analysis, Quality Assurance, Change Management, Agile Methodology, Strategic Planning, Resource Allocation, Performance Metrics, Vendor Management, Workflow Optimization, Healthcare Policies, Regulations, Clinical Operations, Leadership, Time Management, Communication Skills, Process Mapping, Training and Development, Healthcare Analytics, Regulatory Affairs, Medicaid Claims Expertise, Product Owner, Product knowledge, Claims Configuration & Payment Leadership, Process Management & Optimization

Pay Range: $77,969 - $155,508 / ANNUAL

Actual compensation may vary based on geographic location, work experience, education, and skill level.