Molina Healthcare Inc. Logo

Molina Healthcare Inc.

Program Manager (Claims - MST hours)

Posted 3 Hours Ago
Be an Early Applicant
In-Office or Remote
Hiring Remotely in United States
Mid level
In-Office or Remote
Hiring Remotely in United States
Mid level
Manage claims program governance, policies, workflows, controls, budgets and vendor practices. Drive portfolio/initiative change, create requirement/test/training documentation, track metrics, coordinate governance meetings, and recommend program enhancements to improve adoption and value realization.
The summary above was generated by AI

JOB DESCRIPTION

Job Summary

Provides support to Molina functional areas (Claims, and claims configuration) 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. 


Job Duties

  • Responsible for ensuring well-documented policies, workflows, program controls, internal and third-party practices, playbooks and best practices for respective claims & claims configuration program.     
  • Manages program budget, as applicable, supporting project prioritization.
  • Collaborates with Legal, Compliance, and Information Security to ensure governance standards are upheld.
  • 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.

PREFERRED QUALIFICATIONS:

  • Clams & claims configuration experience.
  • QNXT
  • Provider Relations

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. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Similar Jobs

52 Minutes Ago
Remote
California, USA
76K-200K Annually
Junior
76K-200K Annually
Junior
Artificial Intelligence • Healthtech • Machine Learning • Natural Language Processing • Biotech • Pharmaceutical
Pharmaceutical sales role promoting migraine therapy within a defined territory. Drives sales through in-person and virtual HCP engagement, develops and executes territory call plans, leverages analytics and approved clinical information, collaborates cross-functionally, and completes administrative and compliance requirements.
3 Hours Ago
In-Office or Remote
140K-190K Annually
Mid level
140K-190K Annually
Mid level
Greentech • Hardware • Internet of Things • Machine Learning • Software • Business Intelligence • Agriculture
Drive new business and customer success across SE Wyoming by prospecting, performing in-field sales and onboarding, expanding accounts, meeting sales targets, gathering field feedback, collaborating with support, and representing Halter at industry events. Frequent travel and hands-on ranch work required.
3 Hours Ago
Remote or Hybrid
106K-160K Annually
Senior level
106K-160K Annually
Senior level
Cloud • Fintech • Software • Business Intelligence • Consulting • Financial Services
Manage complex tax returns and consulting services for partnership clients, evaluate partnership agreements, mentor staff, and enhance client relationships.
Top Skills: Tax-Related Software

What you need to know about the Boston Tech Scene

Boston is a powerhouse for technology innovation thanks to world-class research universities like MIT and Harvard and a robust pipeline of venture capital investment. Host to the first telephone call and one of the first general-purpose computers ever put into use, Boston is now a hub for biotechnology, robotics and artificial intelligence — though it’s also home to several B2B software giants. So it’s no surprise that the city consistently ranks among the greatest startup ecosystems in the world.

Key Facts About Boston Tech

  • Number of Tech Workers: 269,000; 9.4% of overall workforce (2024 CompTIA survey)
  • Major Tech Employers: Thermo Fisher Scientific, Toast, Klaviyo, HubSpot, DraftKings
  • Key Industries: Artificial intelligence, biotechnology, robotics, software, aerospace
  • Funding Landscape: $15.7 billion in venture capital funding in 2024 (Pitchbook)
  • Notable Investors: Summit Partners, Volition Capital, Bain Capital Ventures, MassVentures, Highland Capital Partners
  • Research Centers and Universities: MIT, Harvard University, Boston College, Tufts University, Boston University, Northeastern University, Smithsonian Astrophysical Observatory, National Bureau of Economic Research, Broad Institute, Lowell Center for Space Science & Technology, National Emerging Infectious Diseases Laboratories

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account