PROGRAM MANAGER, HCS CALIFORNIA
Company: Molina Healthcare
Location: Sacramento
Posted on: November 20, 2024
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Job Description:
For this position we are hiring for our CALIFORNIA health plan.
California residents are preferred.Good Project Management skills,
excellent verbal and written communication skills as well as
on-camera business presentation skills will be essential to be
successful for this role. Training skills helpful. Knowledge of
Utilization Management processes, EMR systems and Health
Information Exchange very helpful. Managed care working knowledge
is preferred.Travel may be required 1x per year, within the state
of California. Candidates who do not live in California must be
willing to work Pacific business hours.JOB DESCRIPTIONJob
SummaryMolina 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.KNOWLEDGE/SKILLS/ABILITIESIn
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
QUALIFICATIONSRequired EducationRegistered 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 Experience5+ 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, AssociationIf
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 EducationMaster's Degree
preferred.Preferred Experience3+ 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,
AssociationAny 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.Pay
Range: $84,067 - $163,931 / ANNUAL*Actual compensation may vary
from posting based on geographic location, work experience,
education and/or skill level.
Keywords: Molina Healthcare, Cupertino , PROGRAM MANAGER, HCS CALIFORNIA, Executive , Sacramento, California
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