Program ManagerLong Beach, California Job ID 1903612
Program Manager with strong analytic and organizational skills. This is a hybrid role that requires Program Management and Sr. Business Analyst skills. Responsibilities include troubleshooting, analyzing and project managing assigned issues to resolution, including post monitoring. Building and maintaining strong relationships and proactive processes are key to the success of this team. The selected candidate would act as the liaison between the business and IT. Monitors the project from inception through delivery. May engage and oversee the work of external vendors. Coordinates with business analyst, IT and business areas, provides and reviews requirements and test results.
Knowledge/Skills/Abilities• Active collaborator with people who are 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.
• Addresses health plan concerns with Enrollment Operations.
• Informs health plans of operational changes within Enrollment Operations. which require health plan communicating to affected state or other regulatory agencies.
• Provides health plan requirements or regulatory changes to Enrollment Operations.
• Strong business knowledge related to lines of business specifically to Medicare/Medicaid.
• Responsible for planning resource needs, improving performance, training needs, support to other business units.
• Subject matter expert of enrollment and provides knowledge and feedback to ensure regulatory and business needs are addressed in projects, health plan initiatives, or any other process impacting enrollment.
• Maintains reports of units’ performance, quality over monthly, quarterly and annual periods for trending; records and manages enrollment issues and works with other business partners to resolve and communicate solutions as needed. (ticketing)
• Ensures staff is compliant with regulatory and company guidelines, including HIPAA compliance.
• This position primarily focuses on project/program management related to the business, rather than the application of expertise in a specialized functional field of knowledge although they may have technical team members. Focuses on process improvement, organizational change management, program management and other processes relative to the business.
• Knowledge related to CMS regulations, reporting requirements, and member material requirements is required.
• Bachelor's Degree or equivalent combination of education and experience
Candidate needs 3-5 years’ experience directly engaged with Medicare eligibility processing to include:
• DTRR/MMR file processing rules
• Graduate Degree or equivalent combination of education and experience
• 5-7 years
• Intermediate SQL
Preferred License, Certification, Association
• PMP Certification (and/or comparable coursework), Six Sigma Black Belt Certification, ITIL Certification desired
related to CMS regulations, reporting requirements, and member material
requirements is required.
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.
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