Clinical Project Manager

Molina Healthcare•Long Beach, CA

About The Position

The Clinical Project Manager (PM) position plays a key role in various multi-functional projects, such as implementation of new programmatic changes, initiatives, or vended solutions; helping to keep migrations on track as well as other projects critical to Molina Healthcare Services in achieving its clinical and operational goals and objectives. The PM's activities address impact on customers, operations, program integrity, pricing, quality and satisfaction. The PM develops and tracks the appropriate metrics to monitor the quality and care cost impact of the program. The PM is responsible for ensuring projects remain on schedule, achieve intended outcomes, and support Molina Healthcare Services in meeting its clinical, operational, and financial objectives. A critical focus of the role is identifying, evaluating, and implementing opportunities that drive cost savings, improve efficiency, and optimize resource utilization while maintaining or enhancing quality of care and member outcomes. The PM assesses project impacts across customers, operations, program integrity, pricing, quality, satisfaction, and medical and administrative costs. Through collaboration with business stakeholders, the PM develops, monitors, and reports on key performance indicators and financial metrics that measure program effectiveness, return on investment, care cost reduction, and overall value delivered to Molina. The PM is accountable for ensuring projects achieve measurable business results, including sustainable cost savings and operational efficiencies that contribute to Molina's long-term success.

Requirements

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.

Nice To Haves

Prior experience with cost of care reduction.
Project Management Professional (PMP) or similar certification.

Responsibilities

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.