Sr. Program Manager with strong analytic, organizational skills and the ability to independently resolve issues and remove hurdles. This is a hybrid role that requires Program Management and Sr. Business Analyst skills. Responsibilities include troubleshooting, analyzing, project managing assigned issues to resolution, review of redeployment and post deployment monitoring. Building and maintaining strong relationships and proactive processes are key to the success of this team and working directly with the Department Director. The selected candidate would act as the liaison between the business and IT and would support Program Managers in a subject matter expert capacity. May engage and oversee the work of external vendors. Coordinates with business analyst, IT and business areas, provides and reviews requirements and test results.
Manage and deliver Enrollment Enterprise wide project initiatives from inception through delivery.
Subject matter expert of enrollment to Program Managers and in functional areas (Inbound and Outbound).
Communicates and collaborates with customers 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 for any process 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 expert and to deliver products from design to completion.
Subject matter expert of enrollment and provides knowledge and feedback to ensure regulatory and Addresses health plan concerns within Enrollment Operations.
Researches, interpret, define and summarize enhancement recommendations.
Provides health plan requirement recommendations.
Responsible for managing deliverables, improving performance, training needs, support to 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 and communicates status for 20-30 assignments.
Ensures compliant with regulatory and company guidelines, including HIPAA compliance.
This position primarily focuses on project/program management related to the business projects, rather than the technical application projects.
Focuses on process improvement, organizational change management, program management and other processes relative to the business.
Participate and led brainstorming sessions to develop new concepts to build efficiencies.
Reviews, and approves test cases for assignments.
Bachelor's Degree or equivalent combination of education and experience.
5 years experience with eligibility processing, including eligibility applications and files.
Extensive Healthcare knowledge.
Knowledge of enrollment files including extracts.
Program and or Project Management experience.
Sr. Business or Systems Analyst experience.
Process Improvement experience.
Required License, Certification, Association
PMP Certification (and/or comparable coursework)
Graduate Degree or equivalent combination of education and experience
Intermediate SQL experience.
Knowledge related to enrollment & eligibility, ID cards, PCP Assignment, Member Materials.
Knowledge of CMS regulations, reporting requirements and member material requirements.
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.