Molina Healthcare

Program Manager- Quality Compliance - Remote CA

Molina Healthcare • $90K — $120K *
Long Beach, CA 90802In-Person
Healthcare
Less than 5 years of experience
2 weeks ago
Job Overview by Ladders

Qualifications

  • 4+ years of experience in Program and/or Project management or a relevant educational background.
  • Experience in Operational Process Improvement.
  • Background in Managed Care, ideally within a shared service or matrixed environment.
  • Proficiency in Microsoft Project and Visio for project management.
  • Excellent presentation and communication capabilities.
  • Familiarity with NCQA Accreditation standards, HEDIS, CAHPS, and state regulatory requirements.
  • Strong project management skills with a focus on timeline management and compliance communication.

Responsibilities

  • Document policies, workflows, and best practices for program management.
  • Oversee the program budget to aid project prioritization.
  • Collaborate with leadership to ensure Quality compliance with regulatory standards.
  • Serve as the primary liaison between departments to align workflows with NCQA requirements.
  • Evaluate accreditation guidelines and monitor performance metrics for compliance.
  • Prepare and submit documentation for regulatory compliance and NCQA accreditation.
  • Coordinate meetings to support governance and decision-making processes.

Benefits

  • Comprehensive benefits package.
  • Opportunities for professional development and growth.
  • Supportive work environment, encouraging collaboration and innovation.
  • Flexible work arrangements available.
Full Job Description
Job Description

JOB DESCRIPTION

****Candidates must reside in California.*****

Job Summary

Provides support to Molina functional areas through program management, including policy, workflow and process documentation, management of program controls, vendor practices, budgets, governance frameworks, playbooks and best practices, and champion networks, as applicable.
  • Responsible for ensuring well-documented policies, workflows, program controls, internal and third-party practices, playbooks and best practices for respective program.
  • Manages program budget, as applicable, supporting project prioritization.
  • Collaborates with leadership on projects that support Quality compliance with regulatory and accreditation efforts.
  • Act as the primary liaison between internal departments (e.g., CA Quality, MHI Quality, Healthcare Services, Government Contracts, Network, Compliance, etc.) to ensure policies, procedures, and workflows align with NCQA requirements.
  • Evaluate and interpret accreditation guidelines at least annually, monitoring performance metrics (HEDIS, CAHPS) to ensure compliance with standards.
  • Prepares and submits necessary documentation, reports, and evidence of compliance for regulatory compliance and NCQA accreditation.
  • Tracks performance metrics and ensures value realization from deployed solutions.
  • Coordinates recurring meetings to support governance framework and decision-making processes, as needed.
  • At the direction of program (CoE, Shared Service or other functional area) leadership, supports portfolio management and/or initiative-specific change and project management.
  • Collaborates with key stakeholders to support dissemination and adoption of program guardrails, processes, best practices and other collateral.
  • Routinely reviews program collateral to ensure current and accurate reflection of business needs.
  • Identifies opportunities/gaps and provides recommendations on program enhancements to respective leadership team.
  • Responsible for creating business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations.
  • Generates and distributes standard reports on schedule.


JOB QUALIFICATIONS

REQUIRED QUALIFICATIONS:
  • At least 4 years of Program and/or Project management experience, or equivalent combination of relevant education and experience.
  • Operational Process Improvement experience.
  • Managed Care experience, preferably in a shared service, CoE or matrixed environment.
  • Experience with Microsoft Project and Visio.
  • Strong presentation and communication skills.
  • Understanding of NCQA Accreditation standards, HEDIS, CAHPS and state regulatory requirements (DHCS, DMHC).
  • Strong project management skills, including ability to manage timelines, facilitate meetings and communicate changes in NCQA accreditation standards and state regulations.
  • Proficient in Microsoft Office


To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package.

About Molina Healthcare

Molina Healthcare focuses exclusively on government-sponsored health care programs for families and individuals who qualify for government-sponsored health care. It contracts with state governments and serves as a health plan, providing a wide range of quality health care services to families and individuals.

Molina Healthcare Careers

Join the dedicated team at Molina Healthcare, a leader in providing quality healthcare services to families and individuals who qualify for government-sponsored programs, including Medicaid and Medicare. As one of the most respected companies in the health services industry, Molina Healthcare offers unparalleled job opportunities aimed at empowering your career growth and professional development.

Work You’ll Do

At Molina Healthcare, you will engage in meaningful work that directly impacts lives across the country. Our team is committed to innovation in healthcare, ensuring that all members receive the best care possible. By joining us, you will collaborate with skilled professionals dedicated to our mission of providing accessible, high-quality healthcare.

Career Opportunities and Growth

Whether you are looking for your first job, seeking a leadership role, or aiming to specialize in healthcare professions, Molina Healthcare offers a range of career paths. Our job opportunities span across various functions, including clinical services, customer support, IT, project management, and more. We believe in fostering the growth of our employees through professional development, leadership training, and diversity initiatives.

Internship Programs

Kickstart your career with a Molina Healthcare internship. Our internships provide invaluable workplace experience, offering a glimpse into the healthcare industry through hands-on projects and mentorship. Interns at Molina Healthcare gain critical skills that prepare them for future employment, making them competitive candidates in the job market.

Culture and Benefits

Molina Healthcare is not just a company; it’s a community. We prioritize a culture of inclusivity and respect, where all team members are encouraged to bring their whole selves to work. Our employees enjoy comprehensive benefits, including health insurance, retirement plans, and wellness programs, all designed to support both their professional and personal lives.

Join Our Team

Explore the various positions available at Molina Healthcare and find where your skills and interests align with our needs. We are continuously hiring talented individuals who are passionate about making a difference in healthcare. Prepare your resume, sharpen your interview skills, and become part of a team that values hard work and creativity.

Stay Connected

Keep up to date with the latest at Molina Healthcare: - **Career Growth and Networking:** Advance your career through our professional development and networking opportunities. Learn from leaders and peers alike to build connections that propel your career forward. - **Innovation and Leadership:** Drive change and lead with confidence by participating in our leadership and innovation training programs.

Apply Now

Ready to take the next step in your healthcare career? Search open positions that match your skills and interests on the Molina Healthcare Jobs portal. We look for driven, curious, and compassionate team players ready to make an impact.

Stay Informed

Subscribe to Molina Healthcare job alerts and receive updates on new openings and company news directly to your inbox. Tailor your subscription to match your career preferences and stay ahead in the dynamic field of healthcare. Join Molina Healthcare, where your career is nurtured, your contributions are valued, and your growth is guaranteed.
Learn more about Molina Healthcare
Size
14,000 employees
Market Cap
$19.5 billion
Industry
Healthcare
Net Income
$673 million
Founded
1980
5 Year Trend
+9.3%
Revenue
$19.4 billion
NASDAQ
MOH
* Ladders Estimates

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