Job description

Job Description

Program Manager with strong analytic, detail oriented and organizational skills. Responsible for Enrollment internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products though the design process to completion. This unique role requires a candidate who is a hybrid between Program Manager, Sr Business Analyst and Systems Analyst. Big picture and proactive process thinking will be key to the success of this role.

Knowledge/Skills/Abilities

This position primarily focuses on project/program management related to the business for overall process improvement, organizational change management, program management and other processes relative to the business.

Responsibilities include troubleshooting, analyzing, planning and project management to resolution, including post monitoring

Subject matter expert of enrollment processes (i.e..834, ID cards, DTRR’s, Premium Billing, extracts) with ability to provide knowledge and feedback to ensure regulatory and business needs are addressed in projects, health plan initiatives, or any other process impacting enrollment

Liaison between the Operations Team and IT

Ability to identify upstream and downstream impacts

Ability to successfully support 15-20 assignments and provide weekly status updates

Drives assignments and remove hurdles independently to meet planned deliverables

Reviews requirements related to assignments for complete understanding of request

Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements

Coordinates and provides guidance to assigned business analyst

Manages project from inception through delivery. May engage and oversee the work of external vendors.

Manages, builds timelines, and communicates status for 20-27 assignments simultaneously

Responsible for meeting weekly with customer and sharing status of request within scope of work

Reviews, and approves test cases for projects to support first resolution by avoiding introducing defects into production

Candidate must be able to independently resolve issues and remove hurdles

Candidate must be self-sufficient, utilize resources and articulate findings

Identify root cause, function and process improvement opportunities that are critical to effective outcome, thinking of upstream and downstream impacts

Strong leadership skills with the ability to bring the right resources together and drive a solution

Responsible for identifying changes that will improve key enrollment metrics, resulting in realized benefits

Strong business knowledge related to Molina lines of business, with particular knowledge for Marketplace and or Medicare

Knowledge related to CMS regulations, reporting requirements, and member material requirements is required

Job Qualifications

Required Education

• Bachelor's Degree or equivalent combination of education and experience

Required Experience

Candidate needs at least 2 years’ experience within healthcare industry, preferably enrollment

Knowledge of enrollment files, including extracts

Project Management Experience

Sr. Business or System Analyst experience

Proven process Improvement Experience

Preferred Education

Graduate Degree or equivalent combination of education and experience

Preferred Experience

3-5 years within healthcare industry, preferably enrollment.

Intermediate SQL

Knowledge related to enrollment & eligibility, ID cards, PCP Assignment, Member Materials

Medicare knowledge

Preferred License, Certification, Association

• PMP Certification (and/or comparable coursework), Six Sigma Green Belt Certification, Certified Business Analysis Professional (CBAP) a plus
• Knowledge 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.

Pay Range: $66,456.22 - $129,589.63 a year*

• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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