Clinical Project Manager

Molina Healthcare•Long Beach, CA

About The Position

Provides support for multifunctional clinical project management activities, including implementing new programmatic changes, initiatives, and vended solutions, as well as projects supporting clinical and operational goals. Contributes to the overarching strategy for quality, cost-effective member care. The role develops and monitors clinical specialty project plans, coordinates implementation of new specialty programs and processes, and supports development of clinical management products, services, program enhancements, and better practices. It also works across internal departments and external vendors to coordinate program development, reporting, and delivery, while tracking metrics related to quality and care costs and escalating risks to leadership.

Requirements

At least 3 years of experience in clinical operations, preferably in a managed care setting 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 suite and applicable software programs.

Nice To Haves

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

Responsibilities

Develop, implement, and monitor clinical specialty project plans, program requirements, and timelines; ensure necessary support, tools, and technology are available and facilitate follow-up.
Meet with business process owners and other appropriate personnel to identify project goals, objectives, critical success factors, and measures of success.
Participate in developing clinical management products and services, leading development of 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 new specialty programs or processes and serve as a clinical liaison between the company and customers as needed.
Assist in modifying implementation approaches within budget and operational frameworks.
Work jointly with leadership to manage revenue goals and administrative expenses.
Develop and track metrics to monitor program quality and impact on care costs.
Build relationships with key 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 the program development lifecycle.
Maintain project plans for ongoing projects and programs to ensure deliverables are met.
Implement required program or process reporting.
Escalate to leadership when projects or processes are at risk because of missed deliverables.