Project Manager (Claims & Operations - CST business hours)

Molina Healthcare; United States; On-site; USD 90,000 - 120,000; Full time

Benefits offered by this job

Competitive benefits package

Job summary

Molina Healthcare is seeking a Project Manager to plan and direct schedules, budgets, and vendor work from inception through delivery. The role focuses on project management rather than specialized technical work and requires strong oversight of claims-related processes.

Responsibilities include developing detailed project plans, monitoring progress, leading meetings, and submitting status reports to management.

Qualifications

• Manages all aspects of assigned projects including scope, schedule, resources, quality, costs, and change.
• Develops and maintains detailed project plans with milestones and dates.
• Revises project plans to meet changing needs.
• Prepares and submits project status reports to management.
• Schedules and conducts project meetings with agendas and minutes.
• Claims experience: researching issues and assisting escalations.
• Understands health plan processes and enterprise function.
• Broad knowledge of claims, configuration, encounters.

Responsibilities

• Plan and direct project schedules and budgets throughout the lifecycle.
• Oversee and coordinate work of external vendors as needed.
• Assign and monitor system analysis and program staff.
• Provide status updates and risk assessments to leadership.

Skills

Project management

Budget management

Vendor management

Schedule development

Stakeholder communications

Claims experience

Healthcare domain knowledge

Process improvement

Meeting facilitation

Documentation

Education

Associate degree

Bachelor's degree

Job description

JOB DESCRIPTION

Employee for this role will work CST business hours Monday - Friday.

Job Summary

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, rather than the application of expertise in a specialized functional field of knowledge although they may have technical team members.

KNOWLEDGE/SKILLS/ABILITIES

• Manages all aspects of assigned projects throughout the project lifecycle including project scope, schedule, resources, quality, costs, and change.


• Develops and maintains detailed project plan to include milestones, tasks, and target/actual dates of completion.


• Revises project plans as appropriate to meet changing needs and requirements.


• Prepares and submits project status reports to management.


• Schedules and conducts project meetings to include logistics, agendas, and meeting minutes.


• Claims experience (researching claim issues, reviewing configuration for claims, assisting in claim escalations)


• Understands health plan processes and procedures and a general idea of how the enterprise departments function and operate.


• Broad, general knowledge of claims, PDM, configuration, encounters, etc.Claims experience (researching claim issues, reviewing configuration for claims, assisting in claim escalations)


• Understands health plan processes and procedures and a general idea of how the enterprise departments function and operate.


• Broad, general knowledge of claims, PDM, configuration, encounters, etc.

JOB QUALIFICATIONS

Required Education

Associate degree or equivalent combination of education and experience

Required Experience

3-5 years project management experience

Preferred Education

Bachelor's Degree or equivalent combination of education and experience

Preferred Experience

5-7 years project management

3+ years Claims, configuration or encounters experience

Preferred License, Certification, Association

PMP or Six Sigma Green Belt certification

• Molina Healthcare offers a competitive benefits and compensation package.

Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.