Clinical Project Manager

Molina Healthcare•United States,

4d•$59,811 - $129,590

About The Position

Provides support for multifunctional clinical project management activities, including implementing new programmatic changes, initiatives, or vendor solutions, as well as projects that support clinical and operational goals. Contributes to the overarching strategy for providing quality, cost-effective member care. The role develops, implements, and monitors clinical specialty project plans, program requirements, and timelines; coordinates implementation of specialty programs and processes; and maintains project plans and required reporting. It works with business process owners, leaders, internal teams, vendors, and customers to define goals and success measures, develop clinical management products and services, improve programs and operational functions, track quality and care-cost outcomes, and ensure deliverables are met. The position also supports revenue and expense management, provider education, and program enhancements, escalating risks to leadership when deliverables are missed.

Requirements

At least 3 years of experience in clinical operations, preferably in managed care supporting healthcare services, quality, network, pharmacy, or project management, or an equivalent combination of relevant education and experience.
Strong project management skills.
Understanding and knowledge of specialty program integration and clinical initiative development and 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.
Proficiency with Microsoft Office and applicable software programs.

Nice To Haves

Active, unrestricted Registered Nurse (RN) or Licensed Practical Nurse (LPN) license in the state of practice.
Project Management Professional (PMP) certification or similar certification.
Strategic planning and disease management experience.

Responsibilities

Develop, implement, and monitor clinical specialty project plans, program requirements, and timelines, ensuring necessary support, tools, and technology are available and facilitating follow-up.
Meet with business process owners and other personnel to identify project goals, objectives, critical success factors, and success measures.
Participate in developing clinical management products and services, leading clinical program enhancements and better practices.
Assist with developing, enhancing, and maintaining operational functions, policies, clinical support, and provider education.
Oversee or coordinate implementation of specialty programs or processes and serve as a clinical liaison between the company and customers as needed.
Modify implementation approaches within budget and operational frameworks.
Work with leadership to manage revenue goals and administrative expenses.
Develop and track metrics to monitor program quality and care-cost impact.
Build relationships with internal and external contacts and teams to support increased revenue goals.
Communicate across departments and with vendors, supporting functions such as finance, outcomes, communications, and information technology throughout program development.
Maintain project plans for ongoing projects and programs to ensure deliverables are met.
Implement required program and process reporting.
Escalate project or process risks to leadership when deliverables are missed.