Program Manager, LTSS Healthcare Services
About The Position
Molina Healthcare is hiring a remote Program Manager to provide subject matter expertise and leadership for healthcare services. The role supports the design, execution, evaluation, and ongoing support of projects, programs, and processes, while ensuring compliance with regulatory and internal standards, practices, policies, and contractual commitments. The position also contributes to the broader strategy for delivering quality, cost-effective member care. Candidates should have experience with LTSS in some capacity. Additional responsibilities may include implementing new markets, working with health plans to ensure full execution, project management, and supporting audit performance and compliance.
Requirements
- At least 5 years of healthcare experience, including clinical operations experience.
- At least 3 years in one or more of the following areas: utilization management, care management, care transitions, behavioral health, or an equivalent combination of relevant education and experience.
- One of the following credentials: Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC), or Licensed Marriage and Family Therapist (LMFT). Clinical licensure or certification is required only when required by state contract, regulation, business operating model, or state board licensing mandates.
- If licensed, hold an active, unrestricted license in the state of practice.
- Strong analytical and problem-solving skills.
- Strong organizational and time-management skills.
- Ability to work in a cross-functional, professional environment.
- Experience working within applicable state, federal, and third-party regulations.
- Strong verbal and written communication skills.
- Proficiency with Microsoft Office Suite or applicable software programs, and ability to navigate online portals and databases.
- Experience with LTSS in some capacity.
Nice To Haves
- Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or another healthcare or management certification.
- Leadership experience.
- Experience with Medicaid or Medicare populations.
Responsibilities
- Collaboratively plan and execute internal healthcare services projects and programs involving departmental or cross-functional subject matter experts, delivering products from design through completion.
- Communicate program goals, evaluation, and support needs to promote compliance with standardized protocols and processes.
- Engage and oversee external vendors, as needed.
- Focus on process improvement, organizational change management, program management, and other processes related to business needs.
- Serve as a subject matter expert and lead healthcare services programs to meet critical needs.
- Communicate and collaborate with customers to analyze needs and goals and translate them into functional requirements.
- Conduct quality audits to assess healthcare services staff educational needs and service quality, and implement departmental quality initiatives as appropriate.
- Create business requirements documents (BRDs), test plans, requirements traceability matrices (RTMs), user training materials, and other related business documents.
- Potentially support new-market implementations, work with health plans to ensure full execution, and support audit performance and compliance.
Benefits
- Competitive benefits and compensation package.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
No Education Listed
