Program Manager -Payment Integrity/Prepayment Solutions (Remote)

Lensa; City of Yonkers (NY); Remote; USD 77,000 - 156,000; Full time

Job summary

An established industry player is seeking a Program Manager to lead Payment Integrity and Prepayment Solutions. This remote role involves overseeing projects from inception to delivery, engaging with external vendors, and driving process improvements. You'll collaborate with cross-functional teams, manage schedules and budgets, and serve as a subject matter expert. If you have a passion for project management in the healthcare sector and a knack for strategic planning, this opportunity offers a chance to make a significant impact while enjoying a competitive salary and benefits.

Qualifications

• 3-5 years of Program and/or Project management experience.
• Operational Process Improvement experience in the healthcare industry.

Responsibilities

• Collaborate with teams to deliver products from design to completion.
• Plan and direct schedules and project budgets.

Skills

Project Management

Agile

Vendor Management

Process Improvement

Communication

Healthcare Analytics

Education

Bachelor's Degree

Graduate Degree

Tools

Microsoft Project

Visio

Jira

PowerPoint

Excel

Job description

Program Manager - Payment Integrity/Prepayment Solutions (Remote)

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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 claims vendors and their functions. Experience engaging vendors and ensuring technology implementation.
• Coding experience is a plus.
• Familiarity 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 and budgets. Monitors projects from inception to delivery. May oversee external vendors. Assigns, directs, and monitors system analysis and program staff. Focuses primarily on project/program management.

Job Duties:

• Collaborate with teams responsible for internal business projects and programs, delivering products from design to completion.
• Plan and direct schedules and project budgets.
• Monitor projects from inception through delivery.
• Engage and oversee external vendors as needed.
• Focus on process improvement, organizational change management, and program management.
• Lead and manage teams in planning and executing business programs.
• Serve as a subject matter expert and lead programs to meet critical needs.
• Communicate with customers to analyze and transform needs into functional requirements.
• Work with operational leaders to identify process improvement opportunities.
• Create business requirements documents, test plans, and related documentation.
• Generate and distribute standard reports on schedule.
• Travel up to twice per year if needed.

Job Qualifications:

Required Education: Bachelor's Degree or equivalent experience.

Preferred Education: Graduate Degree or equivalent experience.

Required Experience, Skills & Abilities:

• 3-5 years of Program and/or Project management experience.
• Operational Process Improvement experience.
• Healthcare industry experience.
• Proficiency with Microsoft Project and Visio.
• Excellent presentation and communication skills.
• Experience working with leadership across organizations.

Preferred Experience:

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

Preferred Certifications:

• PMP, Six Sigma Green Belt/Black Belt or similar coursework.

To all current Molina employees: Please apply through the intranet.

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

Keywords: Project Management, Healthcare, Data, Claims, Vendor Management, Process Improvement, Agile, Strategic Planning, Leadership, Communication, Healthcare Analytics, Medicaid Claims, Payment Leadership, Process Optimization.

Pay Range: $77,969 - $155,508 annually. Compensation may vary based on location, experience, education, and skills.

Additional Details:

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Project Management, IT
• Industries: IT Services, Consulting