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Molina Healthcare

Project Manager (Claims & Operations - CST business hours)

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Summary

Manages healthcare claims projects end-to-end, coordinating teams and vendors to deliver on scope, budget, and timelines while ensuring compliance with health plan processes.

JOB DESCRIPTION

*Employee for this role will work CST business hours Monday - Friday*

Job Summary

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 project/program management, rather than the application of expertise in a specialized functional field of knowledge although they may have technical team members.

KNOWLEDGE/SKILLS/ABILITIES

  • Manages all aspects of assigned projects throughout the project lifecycle including project scope, schedule, resources, quality, costs, and change.
  • Develops and maintains detailed project plan to include milestones, tasks, and target/actual dates of completion.
  • Revises project plans as appropriate to meet changing needs and requirements.
  • Prepares and submits project status reports to management.
  • Schedules and conducts project meetings to include logistics, agendas, and meeting minutes.
  • Claims experience (researching claim issues, reviewing configuration for claims, assisting in claim escalations)
  • Understands health plan processes and procedures and a general idea of how the enterprise departments function and operate.
  • Broad, general knowledge of claims, PDM, configuration, encounters, etc.Claims experience (researching claim issues, reviewing configuration for claims, assisting in claim escalations)
  • Understands health plan processes and procedures and a general idea of how the enterprise departments function and operate.
  • Broad, general knowledge of claims, PDM, configuration, encounters, etc.

JOB QUALIFICATIONS

Required Education

Associate degree or equivalent combination of education and experience

Required Experience

3-5 years project management experience

Preferred Education

Bachelor's Degree or equivalent combination of education and experience

Preferred Experience

5-7 years project management

3+ years Claims, configuration or encounters experience

Preferred License, Certification, Association

PMP or Six Sigma Green Belt certification

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

What they ask for

Required

  • 3-5 years project management experience
  • Associate degree or equivalent combination of education and experience

Preferred

  • 5-7 years project management
  • 3+ years Claims, configuration or encounters experience
  • PMP or Six Sigma Green Belt certification

Skills

See also

Project Management jobs by country — openings, pay and top skills →

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