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Molina Healthcare Program Manager, Risk Adjustment in Georgetown, Kentucky

JOB DESCRIPTION

Job Summary

Responsible for retrospective risk adjustment programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May engage and oversee the work of external vendors. This pathway may include but will not be limited to collaboration with finance to develop or modify program and vendor budgets; vendor procurement, deployment, and management; and Product Owners of supporting IT systems.

Job Duties

  • Oversee all retrospective risk adjustment programming and provide insightful reporting on trends, opportunities, and progress across the programs.

  • Plans and directs schedules as well as project budgets.

  • Monitors the project from inception through delivery.

  • 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.

  • Leads and manages team in planning and executing business programs.

  • Serves as the subject matter expert in the functional area and leads programs to meet critical needs.

  • Collaborate with Compliance to ensure all risk adjustment programs meet Molina Healthcare, Inc., and Centers for Medicare & Medicaid Services (CMS) guidelines.

  • Works with operational leaders within the business to provide recommendations on opportunities for process improvements.

  • Creates business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations.

  • Excellent instincts for root cause analysis and problem solving

JOB QUALIFICATIONS

REQUIRED EDUCATION :

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

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES :

  • 3-5 years of Program and/or Project management experience.

  • Operational Process Improvement experience.

  • Healthcare experience.

  • Experience with Microsoft Project and Visio.

  • Excellent presentation and communication skills.

  • Experience partnering with different levels of leadership across the organization.

PREFERRED EDUCATION :

Graduate Degree or equivalent combination of education and experience.

PREFERRED EXPERIENCE :

• 5-7 years of Program and/or Project management experience.

• Managed Care experience.

• Experience working in a cross functional highly matrixed organization.

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION :

• PMP, Six Sigma Green Belt, Six Sigma Black Belt Certification and/or comparable coursework desired.

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: $59,810.6 - $129,589.63 / ANNUAL

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

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