Sr. Program Manager - Healthcare Enrollment (Remote)

Lensa; Chandler (AZ); Remote; USD 77,000 - 172,000; Full time

Job summary

A leading company in IT Services and Consulting is seeking a Program Manager to oversee multiple Enrollment internal business projects. This hybrid role requires strong analytic and organizational skills, with responsibilities including project management, vendor oversight, and process improvement. The ideal candidate will have extensive experience in health insurance and a proven track record in managing complex initiatives.

Qualifications

• Minimum 5 years’ experience with eligibility processing and health insurance knowledge.
• PMP Certification required; Six Sigma Black Belt and ITIL preferred.
• 7-9 years of relevant experience.

Responsibilities

• Manage Enrollment Enterprise-wide project initiatives from inception through delivery.
• Act as liaison between business, vendors, IT, and support Program Managers.
• Ensure compliance with regulatory and company guidelines, including HIPAA.

Skills

Analytic skills

Organizational skills

Process improvement

Communication

Education

Bachelor's Degree

Graduate Degree

Job description

Be among the first 25 applicants

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!

Job Summary

Responsible for multiple Enrollment 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 reviews enhancement ROI. Candidate must have strong analytic, organizational skills and the ability to independently resolve issues and remove hurdles. This is a hybrid role that requires Program Management, System Analyst, and Sr. Business Analyst skills. Responsibilities include troubleshooting, analyzing, managing assignments, assisting team members, oversight of vendor projects, reviewing team outputs, review of deployment requests, and post-deployment monitoring.

Building and maintaining strong relationships and proactive processes are key to the success of this team. The selected candidate would act as the liaison between the business, vendors, IT, and support Program Managers and Business Analysts in a subject matter expert capacity. May engage and oversee the work of external vendors. Coordinates with business analysts, IT, and business areas, providing and reviewing requirements and test results.

Knowledge/Skills/Abilities

• Independently manage and deliver Enrollment Enterprise-wide project initiatives from inception through delivery
• Subject matter expert of enrollment to Program Managers and Analysts and in functional areas (Inbound and Outbound)
• Communicate and collaborate with Operations, Health Plans, and Leadership to analyze and transform needs and goals into functional requirements
• Develop, define, and execute plans, schedules, and deliverables. Monitor programs from initiation through delivery
• Identify root causes, function, and process improvement opportunities critical to effective outcomes
• Lead programs to meet critical needs, including BRD reviews, logic changes, root cause analysis, etc.
• Work with operational leaders to provide recommendations on process improvements
• Collaborate with other teams within Molina to deliver end-to-end processes within Enrollment Accounting
• Act as a subject matter expert of enrollment, providing knowledge and feedback to ensure regulatory compliance and address health plan concerns within Enrollment Operations
• Research, interpret, define, and summarize enhancement recommendations
• Provide health plan requirement recommendations
• Manage deliverables, improve performance, identify training needs, and support other business units
• Possess strong business knowledge related to Medicaid and Medicare lines of business
• Review enrollment issue trends and develop long-term solutions
• Manage, create, and communicate status reports
• Ensure compliance with regulatory and company guidelines, including HIPAA

This position primarily focuses on project/program management related to business projects rather than technical application projects. It emphasizes process improvement, organizational change management, and other business-related processes. The role involves participating in brainstorming sessions to develop efficiencies.

Qualifications include a minimum of 5 years’ experience with eligibility processing, extensive health insurance knowledge, experience with enrollment files, Program Manager experience, Sr. Business or System Analyst experience, and Process Improvement experience.

Job Qualifications

Required Education

Bachelor's Degree or equivalent combination of education and experience

Required Experience

7-9 years

Required License, Certification, Association

PMP Certification (and/or comparable coursework)

Preferred Education

Graduate Degree or equivalent combination of education and experience

Preferred Experience

10+ years

Preferred License, Certification, Association

Six Sigma Black Belt Certification, ITIL Certification 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 - $171,058 / ANNUAL

• Actual compensation may vary based on location, experience, education, and skills.

Additional Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Project Management and IT
• Industries: IT Services and Consulting