Program Manager, HCS Remote based in Bellevue WA

Remote Full-time
Job Description JOB DESCRIPTION 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. This position will be supporting our Washington State Plan. We are seeking a candidate with strong leadership, communication, and interpersonal skills, with proven expertise in strategic planning, risk management, and resource allocation.This individual will oversee all reporting and IT functions, including the transition of manual reporting processes into fully automated solutions. Candidates with an IT background highly preferred. Further details will be discussed during the interview process. Work schedule Monday- Friday 8:00 AM to 5:00 PM PST Remote with in person quarterly meetings. 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. Apply tot his job
Apply Now

Similar Opportunities

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote Full-time

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote Full-time

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote Full-time

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote Full-time

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote Full-time

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote Full-time

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote Full-time

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote Full-time

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote Full-time

USPS Office Helper

Remote Full-time

Contracts & Pricing Execution Manager, US Remote

Remote Full-time

Call Center Sales and Service Representative - Sign-On Bonus - AT&T - Amarillo, TX - Competitive Salary and Comprehensive Benefits Package

Remote Full-time

Remote Medical Billing & Coding Jobs (No Experience Required)

Remote Full-time

DVC Sales Coordinator

Remote Full-time

Sales / GTM Recruiter | Remote + Great Comp | Career Defining Role

Remote Full-time

Cloud Business Consultant

Remote Full-time

Creative AI Consultant (Enterprise & Studio Partnerships)

Remote Full-time

**Experienced Full Stack Data Entry Specialist – Remote Data Management and Operations**

Remote Full-time

**Experienced Data Entry Specialist – Remote Opportunity with blithequark**

Remote Full-time

Remote Special Education Teaching Role - Michigan K-12 Opening

Remote Full-time
← Back to Home