Program Manager -Payment Integrity/Prepayment Solutions (Remote)

Lensa; Des Moines (IA); Remote; USD 75,000 - 115,000; Full time

Job summary

An innovative healthcare organization is seeking a Program Manager to lead Payment Integrity and Prepayment Solutions initiatives. This remote role focuses on managing internal business projects, ensuring successful delivery through effective planning and collaboration with cross-functional teams. The ideal candidate will possess strong project management skills, a solid understanding of claims processing, and experience in the healthcare industry. You will have the opportunity to drive process improvements and lead teams to achieve critical business objectives while enjoying a competitive compensation package and benefits. If you're passionate about making a difference in healthcare, this role is perfect for you.

Qualifications

• 3-5 years of Program and/or Project management experience.
• Healthcare industry experience is required.
• PMP or similar certifications preferred.

Responsibilities

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

Skills

Claims Processing Knowledge

Project Management

Agile Methodology

Jira

PowerPoint

Excel

Operational Process Improvement

Excellent Communication Skills

Education

Bachelor's Degree

Graduate Degree

Tools

Microsoft Project

Visio

QNXT

Job description

Program Manager - Payment Integrity/Prepayment Solutions (Remote)

2 days ago Be among the first 25 applicants

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 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 as well as project budgets. Monitors the project from inception through delivery. May engage and oversee external vendors. Assigns, directs, and monitors system analysis and program staff. The primary focus is project/program management.

Job Duties:

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

Job Qualifications:

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

Preferred Education: Graduate Degree or equivalent.

Required Experience/Skills:

• 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 collaborating with leadership at various levels.

Preferred Experience:

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

Preferred Certifications:

• PMP, Six Sigma Green Belt, Six Sigma Black Belt, or similar certifications.

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

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