Program Manager (Medicare Enrollment & Eligibility)

Molina Healthcare • Everett, WA

237d • $77,969 - $155,508

About The Position

Responsible for leading Medicare and duals internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May engage and oversee the work of external vendors. Assigns, directs and monitors system analysis and program staff. These positions' primary focus is product management & Product Ownership.

Requirements

• Bachelor's Degree or equivalent combination of education and experience.
• 3-5 years of Program and/or Project management experience.
• Operational Process Improvement experience.
• Healthcare experience.
• Experience with Microsoft Project and Visio.
• Excellent presentation and communication skills.
• Experience partnering with different levels of leadership across the organization.

Nice To Haves

• Graduate Degree or equivalent combination of education and experience.
• 5+ years of Program and/or Product management experience.
• Medicare Managed Care experience.
• Experience working in a cross functional highly matrixed organization.
• PMP, Six Sigma Green Belt, Six Sigma Black Belt Certification and/or comparable coursework desired.

Responsibilities

• Active collaborator with people who are responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion.
• Subject matter expert of enrollment and provides knowledge and feedback to ensure regulatory and business needs are addressed in projects, health plan initiatives, or any other process impacting enrollment.
• Informs health plans of operational changes within Enrollment Operations which require health plan communicating to affected state or other regulatory agencies.
• Knowledge related to CMS regulations, reporting requirements, and member material requirements is required.
• Experience with 834 EDI files.
• SQL experience.
• Plans and directs schedules as well as project budgets.
• Monitors the project from inception through delivery.
• 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.
• Leads and manages team in planning and executing business programs.
• Serves as the subject matter expert in the functional area and leads programs to meet critical needs.
• Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements. Delivers the appropriate artifacts as needed.
• Works with operational leaders within the business to provide recommendations on opportunities for process improvements.
• Creates business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations.
• Generate and distribute standard reports on schedule.

Benefits

• Competitive benefits and compensation package.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree