Program Manager -Payment Integrity/Prepayment Solutions (Remote)

Lensa; Orlando (FL); Remote; USD 80,000 - 110,000; Full time

Job summary

An established industry player is seeking a Program Manager to lead Payment Integrity and Prepayment Solutions. This remote role focuses on managing internal business projects, ensuring timely delivery and effective collaboration with cross-functional teams. The ideal candidate will possess strong project management skills, a deep understanding of claims processing, and experience in the healthcare sector. With a commitment to process improvement and operational excellence, this position offers an exciting opportunity to drive impactful projects while working with diverse teams. Join a dynamic environment where your expertise can make a significant difference.

Qualifications

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

Responsibilities

• Collaborate with teams to deliver products through design processes.
• Plan and monitor projects from inception through delivery.

Skills

Claims Processing Knowledge

Project Management

Agile Methodology

Jira

Microsoft Excel

Communication Skills

Operational Process Improvement

Education

Bachelor's Degree

Graduate Degree

Tools

Microsoft Project

Visio

PowerPoint

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 the 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 experience.
• Proficiency in Agile, Jira, PowerPoint, Excel.
• Understanding of claims vendors and experience engaging with them to ensure 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 project budgets. Monitors projects 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, delivering products through the design process 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 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 identify opportunities for process improvements.
• Create business requirements documents, test plans, traceability matrices, training materials, and related documentation.
• Generate and distribute 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.
• Experience 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, cross-functional organization.

Preferred Certifications:

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

Interested internal Molina employees should apply through the intranet.

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