Sr. Program Manager - Healthcare Enrollment (Remote)

Lensa; Cincinnati (OH); Hybrid; USD 77,000 - 172,000; Full time

Job summary

A leading company in IT Services is seeking a mid-senior level Project Manager to oversee Enrollment internal business projects. The role requires strong analytical and organizational skills, with a focus on process improvement and compliance within the healthcare sector. Candidates should have extensive experience in project management and health insurance, along with relevant certifications.

Qualifications

• Minimum of 5 years’ experience with eligibility processing.
• PMP Certification or comparable coursework required.
• Extensive knowledge in health insurance.

Responsibilities

• Manage and deliver Enrollment Enterprise-wide project initiatives.
• Act as liaison between business, vendors, IT, and support teams.
• Monitor programs from initiation through delivery.

Skills

Analytical skills

Organizational skills

Problem solving

Process improvement

Communication

Education

Bachelor's Degree

Graduate Degree

Job description

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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!

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 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 cause, 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.
• Focus on process improvement, organizational change management, and other related processes.
• Participate and lead brainstorming sessions to develop new concepts for efficiency.
• Ideally possess minimum of 5 years’ experience with eligibility processing, including applications and files.
• Have extensive knowledge in health insurance.
• Knowledge of enrollment files, including extracts.
• Program Manager experience.
• Senior Business or System Analyst experience.
• 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 interested, 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.

Seniority level

• Mid-Senior level

Employment type

• Full-time

Job function

• Project Management and Information Technology

Industries

• IT Services and IT Consulting