Sr. Program Manager - Healthcare Enrollment (Remote)

Lensa; Covington (KY); Hybrid; USD 77,000 - 172,000; Full time

Job summary

A leading healthcare company is seeking a Senior Program Manager to oversee multiple Enrollment projects. This hybrid role requires strong project management skills, with responsibilities including troubleshooting, managing assignments, and collaborating with cross-functional teams to enhance enrollment processes. Ideal candidates will have extensive experience in health insurance and project management.

Qualifications

• Minimum 5 years’ experience in eligibility processing.
• Strong knowledge in health insurance.
• PMP Certification required.

Responsibilities

• Manage and deliver Enrollment Enterprise wide project initiatives.
• Act as liaison between business, vendors, IT, and support teams.
• Lead programs to meet critical needs including BRD reviews.

Skills

Analytic skills

Organizational skills

Process Improvement

Project Management

Communication

Education

Bachelor's Degree

Graduate Degree

Job description

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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 review 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 request 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, provides and reviews 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
• Develops, defines, and executes plans, schedules, and deliverables. Monitors programs from initiation through delivery
• Identify root cause, function and process improvement opportunities that are critical to effective outcome
• Leads programs to meet critical needs. Including but not limited to BRD reviews, logic changes, root cause analysis, etc.
• Works with operational leaders within the business to provide recommendations on opportunities for process improvements
• Collaborate with other teams within Molina to deliver end-to-end processes within Enrollment Accounting Team
• Active collaborator responsible for operation projects and programs involving enrollment and eligibility
• Works with cross-functional teams and IT and business subject matter experts to deliver products from design to completion
• Subject matter expert of enrollment, providing knowledge and feedback to ensure regulatory compliance and address health plan concerns within Enrollment Operations
• Researches, interprets, defines and summarizes enhancement recommendations
• Provides health plan requirement recommendations
• Responsible for managing deliverables, improving performance, training needs, and supporting other business units
• Strong business knowledge related to Medicaid and Medicare lines of business
• Reviews enrollment issue trends and provides long-term solutions as needed
• Manages, creates, and communicates status reports
• Ensures 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
• Focuses on process improvement, organizational change management, and other business-related processes
• Participates and leads brainstorming sessions to develop new concepts to build efficiencies
• Ideally possesses a minimum of 5 years’ experience with eligibility processing, including applications and files
• 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 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 from posting based on geographic location, work experience, education and/or skill level.

Additional Details

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

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