Project Manager (Claims & Operations - CST business hours)

Posted Yesterday
Hiring Remotely in United States
Remote
Mid level
Insurance
The Role
Manages projects from initiation through delivery, including scope, schedules, budgets, resources, quality, costs, risks, and change management. Develops project plans, tracks milestones, prepares status reports, and leads project meetings. Oversees external vendors and coordinates system analysis and programming staff. Requires knowledge of health plan operations, claims, configuration, PDM, encounters, and claim escalations.
Summary Generated by Built In

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.

Skills Required

  • Associate degree or equivalent combination of education and experience
  • 3-5 years of project management experience
  • Bachelor's degree or equivalent combination of education and experience
  • 5-7 years of project management experience
  • 3 or more years of claims, configuration, or encounters experience
  • PMP or Six Sigma Green Belt certification
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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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