Job Description

JOB DESCRIPTION Job SummaryProvides support for multi-functional clinical project management activities, including implementation of new programmatic changes, initiatives, or vended solutions, in addition to projects supporting clinical and operational goals and objectives. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

• Develops, implements, and monitors clinical specialty project plans/program requirements and timelines - ensuring all necessary support, tools and technology are available, and facilitates follow-up as needed.

• Meets with business process owners and other appropriate personnel to identify project goals, objectives, critical success factors and success measures.

• Participates in the development of clinical management products and services - leading the development of clinical program enhancements and better practices.

• Assists with development, enhancement, and maintenance of operational functions, policy and clinical support and provider education.

• Oversees/coordinates implementation of new specialty programs or processes and serves as a clinical liaison between the company and customers as needed - ensuring appropriate implementation and monitoring, or programmatic changes.

• Assists in modifying implementation approaches within budget and operational framework.

• Works jointly with leadership to ensure revenue goals and administrative expenses are managed.

• Develops and tracks appropriate metrics to monitor quality and care cost impact of programs.

• Develops strong relationships with key contacts and teams internally and externally that support achievement of increased revenue goals.

• Communicates across all departments, and/or vendors and supports other functions as needed throughout the program development lifecycle including finance, outcomes, communications and information technology.

• Maintains project plans for ongoing projects/programs to ensure deliverables are met.

• Responsible for implementation of any required programs/process reporting.

• Escalates to leadership when project/processes are at risk as a result of missed deliverables.

Required Qualifications

• At least 3 years experience in clinical operations, preferably in a managed care setting supporting healthcare services, quality, network , pharmacy, and/or project management, or equivalent combination of relevant education and experience. Strong project management skills.

• Understanding and knowledge of specialty programs integration and clinical initiative development/implementation.

• Data management and analytics expertise.

• Excellent problem-solving and organizational skills.

• Ability to work collaboratively across a highly matrixed organization.

• Strong interpersonal skills.

• Excellent verbal and written communication skills.

• Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications

• Registered Nurse (RN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice.

• Project Management Professional (PMP) or similar certification.

• Strategic planning and disease management 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