Program Manager -Payment Integrity/Prepayment Solutions (Remote)

Molina Healthcare; Lexington (KY); Remote; USD 77,000 - 156,000; Full time

Job summary

A leading healthcare organization is seeking a Project Manager to oversee internal business projects involving cross-functional teams. Candidates must possess 3-5 years of project management experience, operational process improvement skills, and a background in healthcare. The role requires excellent communication and presentation abilities, with a competitive salary range of $77,969 - $155,508 annually.

Qualifications

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

Responsibilities

• Collaborate on internal business projects and programs.
• Plan schedules and project budgets.
• Monitor project from inception to delivery.
• Engage and oversee external vendors.

Skills

Claims processing knowledge

Project Management

Agile methodology

Jira

Excel

Technical Project Management

Education

Bachelor's Degree

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.