Job DescriptionJOB DESCRIPTIONJob SummaryThe Program Director, Clinical Data Acquisition leads enterprise level programs and initiatives within Molina's Risk Adjustment Clinical Data Acquisition team, overseeing the planning, execution, and optimization of clinical data retrieval, provider engagement, and risk adjustment education programs across all lines of business (Medicare, Medicaid, and Marketplace). This role is responsible for managing complex internal business projects and cross functional teams of subject matter experts, ensuring accurate and timely collection of medical records and clinical data that support Risk Adjustment performance and compliance with CMS and State requirements.
The Program Director provides governance and strategic direction across a diverse portfolio of operational and technology driven initiatives. This includes creating structured project plans, managing roadmaps, managing budgets and schedules, monitoring progress from inception through delivery, and overseeing vendor partnerships as needed. The role requires strong project and program leadership, including the ability to quickly assimilate information, make data driven decisions, manage ambiguity, and guide teams through fast paced, cross departmental efforts.
In partnership with Corporate EPMO, IT, and executive leadership, the Program Director ensures consistent governance, issue escalation and resolution, and adherence to portfolio and project management best practices. The position requires extensive communication and presentation capabilities to influence senior leaders and support provider education, process improvement, and software/technology implementations. Responsibilities also include developing high impact materials such as executive level PowerPoint presentations, marketing collateral, program documentation, and stakeholder communications that support program success and provider engagement.
Knowledge, Skills & Abilities - Leads the strategic planning, execution, and delivery of clinical data acquisition programs supporting enterprise Risk Adjustment goals and regulatory obligations.
- Serves as industry Subject Matter Expert in the functional area and leads programs to meet critical needs
- Escalates gaps and barriers in implementation and compliance to AVP and Director as appropriate.
- Consultative role, develops business case methodologies for programs, develops and coordinates implementation of business strategy
- Develops and maintains comprehensive project plans, charters, roadmaps, and performance dashboards for multiple concurrent initiatives.
- Ensures accurate, compliant, and timely delivery of data for Risk Adjustment initiatives across Medicare, Medicaid, and Marketplace lines of business.
- Partners with operational and technical teams to enhance data workflows, improve retrieval efficiency, and streamline provider
- facing processes.
- Supports the development and rollout of provider education strategies and materials related to documentation, data submission, and risk adjustment accuracy.
- Aides in developing provider facing and internal communication materials, including marketing collateral, education content, and informational guides.
- Ensures transparency and consistency in project reporting, escalation pathways, and stakeholder communication plans.
- Identifies opportunities for workflow enhancement, automation, and process redesign within clinical data acquisition.
- Applies structured project management, change management, and continuous improvement methodologies.
- Extensive expertise in project and program management, including governance, risk management, and portfolio management frameworks.
- Strong leadership and influencing skills with ability to motivate cross functional teams and drive outcomes in complex environments.
- Deep understanding of CMS & State risk adjustment and Quality programs, medical record retrieval workflows, and clinical documentation principles.
- Ability to manage competing priorities, large scale initiatives, and ambiguity in a fast paced environment.
JOB QUALIFICATIONSRequired EducationBachelor's degree or equivalent combination of education and experience
Required Experience7-9 years
Preferred EducationGraduate Degree or equivalent combination of education and experience
Preferred Experience10+ years
Preferred License, Certification, AssociationCPHQ
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.
