Program Manager -Payment Integrity/Prepayment Solutions (Remote)

Lensa; Sioux City (IA); Remote; USD 70,000 - 110,000; Full time

Job summary

An established industry player is seeking a Program Manager for Payment Integrity and Prepayment Solutions. This remote position involves managing cross-functional projects, focusing on process improvement and organizational change. The ideal candidate will have extensive experience in project management, particularly within the healthcare sector, and will be responsible for collaborating with teams, overseeing external vendors, and ensuring successful project delivery. Join a forward-thinking organization that values innovation and offers competitive benefits.

Qualifications

• 3-5 years of Program/Project management experience required.
• Operational process improvement experience in healthcare is essential.

Responsibilities

• Manage internal projects from design to completion, overseeing budgets and schedules.
• Lead process improvements and communicate with stakeholders effectively.

Skills

Claims Processing Knowledge

Payment Integrity Solutions

Project Management

Technical Project Management

Agile Proficiency

Jira Proficiency

PowerPoint Proficiency

Excel Proficiency

Coding Experience

QNXT Familiarity

Education

Bachelor's Degree

Graduate Degree

Tools

Microsoft Project

Visio

Jira

Job description

Program Manager - Payment Integrity/Prepayment Solutions (Remote)

Molina Healthcare is seeking a Program Manager – Payment Integrity/Prepayment Solutions Implementation. This remote role is available in specific states we are hiring in.

Highly Qualified Candidates Will Have the Following Experience

• Knowledge of claims processing and claims vendors.
• Experience with Payment Integrity and/or Prepayment solutions.
• Project Management and/or Technical Project Management skills.
• Proficiency in Agile, Jira, PowerPoint, Excel.
• Coding experience is a plus. Familiarity with QNXT is also a plus.

Job Summary

Responsible for managing internal projects and programs involving cross-functional teams, from design to completion. Includes planning, scheduling, budgeting, and overseeing external vendors. Focuses on process improvement and organizational change management.

Job Duties

• Collaborate with teams on internal projects, delivering products through the design process.
• Plan and direct schedules and budgets.
• Monitor projects from inception to delivery.
• Oversee external vendors as needed.
• Lead process improvements and organizational change initiatives.
• Manage and lead teams in planning and executing programs.
• Serve as subject matter expert and align programs with organizational needs.
• Communicate with stakeholders to analyze needs and deliver requirements.
• Create documentation such as business requirements, test plans, and training materials.
• Generate and distribute reports.
• Potential travel up to twice per year.

Job Qualifications

Required Education: Bachelor's degree or equivalent experience.

Preferred Education: Graduate degree or equivalent experience.

Experience, Skills & Abilities

• 3-5 years of Program/Project management experience.
• Operational process improvement experience.
• Healthcare industry experience.
• Experience with Microsoft Project and Visio.
• Excellent communication and presentation skills.
• Ability to work with leadership at various levels.

Preferred Experience

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

Certifications

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

To apply, current Molina employees should use the intranet. Molina offers competitive benefits. We are an Equal Opportunity Employer.