Molina Healthcare

Senior Program Manager - Medicare Network Performance and Operations - Remote

Molina Healthcare$110K — $130K *
US-AnywhereRemote in United States
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's Degree or equivalent experience required
  • 7-9 years of project/program management experience
  • PMP Certification (or similar coursework) required
  • Graduate Degree preferred
  • 10+ years of experience preferred
  • Six Sigma Black Belt Certification, ITIL Certification desired

Responsibilities

  • Lead submission activities for CMS/HPMS and ongoing monitoring
  • Coordinate with Product and Markets teams for updates on regulatory notices
  • Review regulatory documentation to ensure compliance with CMS requirements
  • Manage teams for business program planning and execution
  • Serve as a subject matter expert for Program Managers and teams
  • Develop and maintain key project documentation including BRDs and user training materials
  • Monitor and manage programs from initiation to delivery

Benefits

  • Comprehensive healthcare package
  • Retirement savings plan
  • Flexible work arrangements
  • Opportunities for professional development
  • Employee wellness programs
Full Job Description
Job Description

JOB DESCRIPTION

Job Summary

Responsible for 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 project budgets. Monitors the project from inception through delivery. May engage and oversee the work of external vendors. Assigns, directs, and monitors system analysis and program staff. These positions' primary focus is project/program management, rather than the application of expertise in a specialized functional field of knowledge although they may have technical team members.

Key Responsibilities / Knowledge, Skills & Abilities:

Leads CMS/HPMS submission activities and ongoing monitoring, including:
  • Health Service Delivery (HSD) tables
  • Exception Requests
  • Service Area Expansions (SAE)
  • Triennial network adequacy reviews
  • What if scenarios to network sculpting

Coordinates with Product and Markets teams to ensure accurate and timely updates related to:
  • Notices of Intent to Apply (NOIAs)
  • Notices of Intent to Deny (NOIDs)
  • Service area withdrawals

Reviews regulatory documentation within Innovare and ensures alignment with CMS requirements, including:
  • Network adequacy guidance
  • Templates
  • Supporting regulatory documentation

Manages leaders and teams responsible for planning and executing business programs.
Assigns, directs, and monitors the work of program management staff.
Serves as a subject matter expert for Program Managers and functional teams.
Leads programs to meet critical business objectives and operational needs.
Collaborates with customers and stakeholders to translate business needs and goals into functional requirements.
Partners with operational leaders to identify and recommend process improvement opportunities.

Develops and maintains:
  • Business requirements documents (BRDs)
  • Test plans
  • Requirements traceability matrices (RTMs)
  • User training materials
  • Related project documentation

Develops, defines, and executes:
  • Program plans
  • Project schedules
  • Deliverables

Monitors and manages programs from initiation through delivery.

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.

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
Net Income
$673 million
Founded
1980
5 Year Trend
+9.3%
Revenue
$19.4 billion
NASDAQ

Similar Jobs

More Jobs at Molina Healthcare

More Healthcare Jobs

Find similar Senior Program Manager - Medicare Network Performance and Operations - Remote jobs: