Sr. Program Manager - Healthcare Enrollment (Remote)

Lensa; Phoenix (AZ); Hybrid; USD 77,000 - 172,000; Full time

Job summary

A leading company is seeking a skilled Program Manager to oversee Enrollment projects. This hybrid role involves managing cross-functional teams, ensuring compliance, and improving processes within Medicaid and Medicare. Candidates should possess strong analytical skills and relevant experience in project management.

Benefits

Competitive benefits

Qualifications

• At least 5 years’ experience with eligibility processing.
• Strong knowledge of Medicaid and Medicare lines of business.

Responsibilities

• Manage and deliver Enrollment Enterprise-wide projects.
• Act as subject matter expert in enrollment for Program Managers and Analysts.
• Collaborate with cross-functional teams to deliver products.

Skills

Analytical Skills

Organizational Skills

Process Improvement

Communication

Education

Bachelor's Degree

Job description

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Job Summary

Responsible for managing multiple Enrollment internal business projects and programs involving department or cross-functional teams of subject matter experts. Deliver products through the design process to completion, including planning, scheduling, and ROI review. The candidate must have strong analytical and organizational skills, with the ability to resolve issues independently. This hybrid role requires Program Management, System Analysis, and Senior Business Analyst skills. Responsibilities include troubleshooting, analyzing, managing assignments, assisting team members, overseeing vendor projects, reviewing team outputs, deployment requests, and post-deployment monitoring.

Building and maintaining strong relationships and proactive processes are key to success. The candidate will act as a liaison between business, vendors, IT, and support Program Managers and Business Analysts, possibly overseeing external vendors. Coordination with business analysts, IT, and business areas is essential for providing and reviewing requirements and test results.

Knowledge/Skills/Abilities

• Manage and deliver Enrollment Enterprise-wide projects from inception through delivery.
• Act as subject matter expert in enrollment for Program Managers and Analysts, covering inbound and outbound processes.
• Communicate and collaborate with Operations, Health Plans, and Leadership to analyze needs and translate them into functional requirements.
• Develop, define, and execute plans, schedules, and monitor programs from initiation to delivery.
• Identify root causes and opportunities for process improvements critical to outcomes.
• Lead programs to meet critical needs, including BRD reviews, logic changes, root cause analysis, etc.
• Collaborate with operational leaders to recommend process improvements.
• Work with cross-functional teams and IT to deliver products from design to completion.
• Provide expertise in enrollment to ensure regulatory compliance and address health plan concerns.
• Research, interpret, define, and summarize enhancement recommendations.
• Recommend health plan requirements.
• Manage deliverables, improve performance, and support training and other business units.
• Possess strong knowledge of Medicaid and Medicare lines of business.
• Review enrollment issue trends and develop long-term solutions.
• Manage and communicate status reports.
• Ensure compliance with regulatory and company guidelines, including HIPAA.
• Focus on project/program management related to business projects, emphasizing process improvement and organizational change management.
• Participate in brainstorming sessions to develop new efficiencies.
• Ideally have at least 5 years’ experience with eligibility processing, including applications and files.
• Have extensive knowledge of health insurance, enrollment files, and extracts.
• Possess Program Manager, Sr. Business, or System Analyst experience.
• Experience in Process Improvement is preferred.

Job Qualifications

Required Education

Bachelor's Degree or equivalent experience.

Required Experience

7-9 years.

Required Licenses/Certifications

PMP Certification or comparable coursework.

Preferred Education

Graduate Degree or equivalent experience.

Preferred Experience

10+ years.

Preferred Certifications

Six Sigma Black Belt, ITIL desired.

To apply, current Molina employees should use the intranet listing. Molina offers competitive benefits. Equal Opportunity Employer. Pay Range: $77,969 - $171,058 annually.