Program Manager -Payment Integrity/Prepayment Solutions (Remote)

Lensa; Tacoma (WA); Remote; USD 80,000 - 110,000; Full time

Job summary

An innovative healthcare organization is seeking a Program Manager to lead Payment Integrity and Prepayment Solutions projects. In this remote role, you will manage cross-functional teams and oversee the entire project lifecycle, ensuring timely delivery and adherence to budgets. You will collaborate with internal and external stakeholders, driving process improvements and organizational change. This is an exciting opportunity to make a significant impact in a dynamic environment, where your expertise in project management and healthcare will be valued. If you're passionate about leading projects and enhancing operational efficiency, this role is made for you.

Qualifications

• 3-5 years of Program and/or Project management experience required.
• Operational Process Improvement experience in healthcare is essential.
• Excellent communication and presentation skills are necessary.

Responsibilities

• Manage internal business projects and programs from design to delivery.
• Collaborate with teams to ensure project schedules and budgets are met.
• Engage and oversee external vendors as needed.

Skills

Claims Processing

Payment Integrity

Project Management

Agile

Jira

PowerPoint

Excel

Vendor Engagement

Coding

QNXT

Education

Bachelor's Degree

Graduate Degree

Tools

Microsoft Project

Visio

Job description

Program Manager - Payment Integrity/Prepayment Solutions (Remote)

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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 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 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 internal teams on 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 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 needs and transform them 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 other 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 working with leadership across organizations.

Preferred Experience:

• 5-7 years of Program and/or Project management experience.
• Managed Care experience.
• Experience in highly matrixed organizations.

Preferred Certifications:

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

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

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