Program Manager -Payment Integrity/Prepayment Solutions (Remote)

Molina Healthcare; Cleveland (OH); Remote; USD 77,000 - 156,000; Full time

Job summary

A leading healthcare provider in Cleveland seeks a Project Manager with 3-5 years of program management experience and strong skills in Agile and communication. The ideal candidate will oversee cross-functional projects, ensure proper budgeting, and engage with external vendors. Required qualifications include a Bachelor's Degree and healthcare experience. A competitive compensation package is offered, ranging from $77,969 to $155,508 annually.

Benefits

Competitive benefits package

Qualifications

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

Responsibilities

• Active collaborator with teams on business projects.
• Plans and directs schedules and project budgets.
• Monitors projects from inception to delivery.
• Focuses on process improvement and program management.
• Serves as subject matter expert and leads programs.
• Communicates and collaborates with customers for requirements.
• Creates business requirements documents and related materials.

Skills

Knowledge of claims / claims processing

Project Management

Technical Project Management

Agile

Jira

PowerPoint

Excel

Coding experience

Familiarity with QNXT

Education

Bachelor's Degree or equivalent experience

Graduate Degree

Tools

Microsoft Project

Visio

Job description

JOB DESCRIPTION

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 who are 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 documentations.

• Generate and distribute 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.

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

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