Project Manager (Appeals & Grievances)

Posted Yesterday
Hiring Remotely in United States
Remote
Mid level
Insurance
The Role
Manages multiple Appeals and Grievances projects from inception through delivery, overseeing scope, schedules, resources, budgets, quality, stakeholders, and change management. Develops project plans, status reports, process documentation, SOPs, workflows, and PEGA job aids. Coordinates process improvements, governance changes, vendors, training, and cross-functional collaboration with executive, operational, and PEGA teams across multiple regions.
Summary Generated by Built In

JOB DESCRIPTION Job Summary

Provides support for internal business projects from inception through delivery.  Plans and managed project schedules, milestones, budgets, stakeholder involvement, and quality/delivery.  Collaborates cross-functionally with departments and cross-functional teams of subject matter experts to ensure project completion and success.

This candidate will be supporting multiple Appeals and Grievances regions


Essential Job Duties

  • Manages all aspects of assigned projects throughout the project lifecycle including project scope, schedule, resources, quality, costs and change; supports projects of moderate to high-level complexity.  
  • Develops and maintains detailed project plans to include milestones, tasks, and target/actual dates of completion.
  • Revises project plans as appropriate to meet changing needs and requirements.
  • Schedules and conducts project meetings to include logistics, agendas, and meeting minutes.
  •  Prepares and submits project status reports to leadership.
  •  Facilitates project follow-up items with applicable stakeholders.
  • Coordinates project-related process improvements, workflow changes, project/program implementation and governance changes, etc.
  • May engage and oversee the work of external vendors.
  • Provides training and support to new and existing project management team members.
  • Act as a liaison between Appeals & Grievances and PEGA teams.
  • Manage SOPs, Workflows, job aide for Pega
  • Create process documents across all states
  • Work with executive teams. 

 

Required Qualifications

  • At least 3 years of professional experience in project management or a related role, or equivalent combination of relevant education and experience.
  • Operational/process improvement experience.
  • Project management experience/skills.
  •  Knowledge of project management methodologies (Waterfall, Agile, or hybrid).
  •  Data analysis skills/experience.
  • Strong problem-solving skills.
  • Strong organizational and time-management skills.
  • Proven ability to manage multiple projects simultaneously with competing priorities.
  •  Ability to create clear, accurate, complete, and concise reports.
  • Ability to effectively lead small meeting and capture concise notes and action items.
  •  Ability to work cross-collaboratively across a highly matrixed organization.
  • Effective verbal/written/presentation communication skills.
  • Microsoft Office suite (including Excel, PowerPoint, Project, and Visio), and applicable software programs proficiency.
     

Preferred Qualifications

  • Project Management Professional (PMP) and/or Six Sigma Green Belt certification.
  • Health care/managed care 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 professional experience in project management or a related role, or an equivalent combination of relevant education and experience.
  • Operational or process improvement experience.
  • Project management experience and skills.
  • Knowledge of Waterfall, Agile, or hybrid project management methodologies.
  • Data analysis skills or experience.
  • Strong problem-solving skills.
  • Strong organizational and time-management skills.
  • Ability to manage multiple projects simultaneously with competing priorities.
  • Ability to create clear, accurate, complete, and concise reports.
  • Ability to lead small meetings and capture concise notes and action items.
  • Ability to collaborate across a highly matrixed organization.
  • Effective verbal, written, and presentation communication skills.
  • Proficiency with Microsoft Office, including Excel, PowerPoint, Project, Visio, and applicable software programs.
  • Project Management Professional certification and/or Six Sigma Green Belt certification.
  • Healthcare or managed care 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..

  • 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.
  • 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.
  • 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

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The Company

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.

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