JOB DESCRIPTION

Program Manager for Healthcare Services available for either RN or a Behavioral Health Specialist who has a license in good standing in their state of residence. The person hired to fill this position will support our Medicaid markets across the Central and Eastern time zones. While the position is fully remote, working from home, there will be 25% or less travel expected. In addition to the qualifications listed below, candidates with Project Management experience/expertise are highly preferred. Having Six Sigma training or certification is a bonus.  Hours worked will be Monday – Friday, 8 AM – 5 PM in your time zone.  

Job Summary

Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.

KNOWLEDGE/SKILLS/ABILITIES

• In collaboration with others, plans and executes internal Healthcare Services projects and programs involving department or cross-functional teams of subject matter experts, delivering products from the design process to completion.
• Manages programs providing ongoing communication of goals, evaluation, and support to ensure compliance with standardized protocols and processes.
• May engage and oversee the work of external vendors.
• Focuses on process improvement, organizational change management, program management and other processes relative to the business.
• Serves as a subject matter expert and leads programs to meet critical needs.
• Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements.
• Works with operational leaders within the business to provide recommendations for process improvement opportunities.
• Conducts quality audits to assess Molina Healthcare Services staff educational needs and service quality and implement quality initiatives within the department as appropriate.
• Creates business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations.

JOB QUALIFICATIONS

Required Education

• Registered Nurse or equivalent combination of Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) with experience in lieu of RN license.
• OR Bachelor's or master’s degree in Nursing, Gerontology, Public Health, Social Work or related field.

Required Experience

• 5+ years of managed healthcare experience, including 3 or more years in one or more of the following areas: utilization management, case management, care transition and/or disease management.
• Minimum 2 years of healthcare or health plan supervisory or managerial experience, including oversight of clinical staff.
• Experience working within applicable state, federal, and third party regulations.

Required License, Certification, Association

• If licensed, license must be active, unrestricted and in good standing.
• Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.

Preferred Education

Master's Degree preferred.

Preferred Experience

• 3+ years supervisory/management experience in a managed healthcare environment.
• Medicaid/Medicare Population experience with increasing responsibility.
• 3+ years of clinical nursing experience.

Preferred License, Certification, Association

Any of the following:

Certified Case Manager (CCM), Certified Professional in Healthcare Management Certification (CPHM), Certified Professional in Health Care Quality (CPHQ), or other healthcare or management certification.

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.

Pay Range: $77,969 - $171,058 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.