Molina Healthcare Inc. Logo

Molina Healthcare Inc.

Project Manager (Appeals & Grievances)

Posted Yesterday
Be an Early Applicant
Remote
Hiring Remotely in United States
Mid level
Remote
Hiring Remotely in United States
Mid level
Manages multiple Appeals and Grievances projects from inception through delivery, overseeing scope, schedules, resources, budgets, quality, stakeholders, and change management. Develops project plans, status reports, process documentation, SOPs, workflows, and PEGA job aids. Coordinates process improvements, governance changes, vendors, training, and cross-functional collaboration with executive, operational, and PEGA teams across multiple regions.
The summary above was generated by AI

JOB DESCRIPTION Job Summary

Provides support for internal business projects from inception through delivery.  Plans and managed project schedules, milestones, budgets, stakeholder involvement, and quality/delivery.  Collaborates cross-functionally with departments and cross-functional teams of subject matter experts to ensure project completion and success.

This candidate will be supporting multiple Appeals and Grievances regions


Essential Job Duties

  • Manages all aspects of assigned projects throughout the project lifecycle including project scope, schedule, resources, quality, costs and change; supports projects of moderate to high-level complexity.  
  • Develops and maintains detailed project plans to include milestones, tasks, and target/actual dates of completion.
  • Revises project plans as appropriate to meet changing needs and requirements.
  • Schedules and conducts project meetings to include logistics, agendas, and meeting minutes.
  •  Prepares and submits project status reports to leadership.
  •  Facilitates project follow-up items with applicable stakeholders.
  • Coordinates project-related process improvements, workflow changes, project/program implementation and governance changes, etc.
  • May engage and oversee the work of external vendors.
  • Provides training and support to new and existing project management team members.
  • Act as a liaison between Appeals & Grievances and PEGA teams.
  • Manage SOPs, Workflows, job aide for Pega
  • Create process documents across all states
  • Work with executive teams. 

 

Required Qualifications

  • At least 3 years of professional experience in project management or a related role, or equivalent combination of relevant education and experience.
  • Operational/process improvement experience.
  • Project management experience/skills.
  •  Knowledge of project management methodologies (Waterfall, Agile, or hybrid).
  •  Data analysis skills/experience.
  • Strong problem-solving skills.
  • Strong organizational and time-management skills.
  • Proven ability to manage multiple projects simultaneously with competing priorities.
  •  Ability to create clear, accurate, complete, and concise reports.
  • Ability to effectively lead small meeting and capture concise notes and action items.
  •  Ability to work cross-collaboratively across a highly matrixed organization.
  • Effective verbal/written/presentation communication skills.
  • Microsoft Office suite (including Excel, PowerPoint, Project, and Visio), and applicable software programs proficiency.
     

Preferred Qualifications

  • Project Management Professional (PMP) and/or Six Sigma Green Belt certification.
  • Health care/managed care experience.
     

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

6 Minutes Ago
In-Office or Remote
Entry level
Entry level
Manufacturing
Talent community for future field-based sales opportunities across Fortune Brands’ building products portfolio. Potential responsibilities include territory and account management, sales strategy, customer relationship development, new business generation, product presentations, channel partnerships, forecasting, CRM management, and collaboration with marketing, product, customer service, and supply chain teams. Candidates should have commercial sales experience, preferably in building materials, distribution, construction, plumbing, retail, dealer, or contractor channels. Regular travel within assigned territories is expected.
Top Skills: Crm PlatformsHubspotMicrosoft DynamicsMS OfficeSalesforce
7 Minutes Ago
Easy Apply
Remote or Hybrid
USA
Easy Apply
200K-350K Annually
Senior level
200K-350K Annually
Senior level
Fintech • Software • Financial Services
Own the reliability and quality of an AI copilot for a trading platform. Build evaluation frameworks, benchmarks, quality gates, monitoring, incident response, and model improvement workflows. Partner with engineering and product to create safe, auditable tool interactions and improve assistant behavior. Develop domain expertise in trading, risk, margin, execution, and portfolio reasoning while operating across model, backend, and frontend systems.
Top Skills: Evaluation PipelinesLlm ApisModel ServingObservability And Telemetry ToolingPostgresReactReact NativeRustTraining PipelinesTypescript
11 Minutes Ago
Easy Apply
Remote
United States
Easy Apply
168K-238K Annually
Entry level
168K-238K Annually
Entry level
Cloud • Security • Software • Cybersecurity • Automation
Lead hands-on product security architecture across GitLab, including design reviews, threat modeling, systemic risk remediation, security standards, prototypes, and reusable developer guardrails. Partner with engineering and product leaders, secure distributed systems and software supply chains, guide AI coding tool security, mentor security engineers, and influence technical direction through proactive architecture and clear communication.
Top Skills: Ai Coding ToolsApplication SecurityDevsecopsDistributed SystemsSoftware Supply Chain SecurityThreat Modeling

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