JOB DESCRIPTION Job Summary
Provides support for multi-functional clinical project management activities, including implementation of new programmatic changes, initiatives, or vended solutions, in addition to projects supporting clinical and operational goals and objectives. Contributes to overarching strategy to provide quality and cost-effective member care.
Essential Job Duties
• 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.
Required Qualifications
• 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.
Preferred Qualifications
• Registered Nurse (RN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice.
• Project Management Professional (PMP) or similar certification.
• Strategic planning and disease management experience.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Skills Required
- At least 3 years of experience in clinical operations, preferably in managed care supporting healthcare services, quality, network, pharmacy, or project management, or equivalent relevant education and experience
- Strong project management skills
- Knowledge of specialty program integration and clinical initiative development and implementation
- Data management and analytics expertise
- Excellent problem-solving and organizational skills
- Ability to collaborate across a highly matrixed organization
- Strong interpersonal skills
- Excellent verbal and written communication skills
- Proficiency with Microsoft Office and applicable software programs
- Active, unrestricted Registered Nurse or Licensed Practical Nurse license
- Project Management Professional certification or similar
- Strategic planning and disease management experience
Molina Healthcare Inc. Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Molina Healthcare Inc. and has not been reviewed or approved by Molina Healthcare Inc..
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Healthcare Strength — Health coverage is described as solid, including medical, dental, and vision insurance alongside options like HSA/FSA and disability coverage. Benefits are often seen as a meaningful part of the overall package.
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Retirement Support — A 401(k) with employer matching and an ESPP are offered, and the retirement plan is commonly regarded as a plus. These features help round out compensation even when base pay is seen as only acceptable.
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Leave & Time Off Breadth — PTO, paid holidays, and paid parental leave are part of the offering, with time‑off benefits generally viewed favorably. Backup family care and an employee assistance program add practical support.
Molina Healthcare Inc. Insights
What We Do
Molina Healthcare Inc. is dedicated to delivering effective, reliable, and affordable health care to those who need it most. The company focuses on improving the health and well-being of its members and positively impacting the communities it serves. Recognized as a leader in the health insurance category, it provides essential healthcare services to ensure accessible and quality care for its members.
