Senior Program Manager - Must Reside in KY (Regulatory/Legal Experience Preferred)

Posted Yesterday
Be an Early Applicant
2 Locations
In-Office or Remote
Senior level
Insurance
The Role
Lead regulatory oversight and managed care contract performance programs, coordinate cross-functional teams, operationalize statutory and contractual changes, advise health plan leaders on compliance and process improvements, manage program staff and external vendors, and deliver projects from initiation through completion.
Summary Generated by Built In

JOB DESCRIPTION

Job Summary

Responsible for oversight of managed care contract performance and regulatory strategy, including internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Serves as subject matter expert for contractual requirements as well as applicable federal and state laws, providing actionable guidance and strategic support to health plan leaders. Monitors requirements from inception through operationalization. May engage and oversee the work of external vendors. Assigns, directs, and monitors requirement systems 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

  • Leads regulatory oversight committee, including identification and analysis of new or amended statutes, regulations, agency policy guidance, executive orders, and contract provisions.
  • Responsible for oversight of the health plan’s managed care contract, including requirement and amendment analysis to support operationalization and compliance across the enterprise.
  • Leads regulatory oversight workgroup, comprised of health plan leaders, in the review and operationalization of regulatory changes that impact multiples lines of business. 
  • Manages people who lead teams in planning and executing business programs.  Assigns and monitors work of program management staff providing support and direction.
  • Serves as the subject matter expert to Program Managers and in functional areas; leads programs to meet critical needs.
  • Works with operational leaders within the business to provide recommendations on opportunities for process improvements.
  • Develops, defines, and executes plans, schedules, and deliverables.  Monitors programs from initiation through delivery.

JOB QUALIFICATIONS

Required Education

Bachelor's Degree or equivalent combination of education and experience

Required Experience

7-9 years

Required License, Certification, Association

PMP Certification (and/or comparable coursework)

Preferred Education

Graduate Degree or equivalent combination of education and experience

Preferred Experience

10+ years

Preferred License, Certification, Association

Six Sigma Black Belt Certification, ITIL Certification desired


#PJCorp

#LI-AC1

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

  • Bachelor's Degree or equivalent combination of education and experience
  • 7-9 years of relevant experience
  • PMP Certification or comparable coursework
  • Must reside in Kentucky
  • Graduate Degree or equivalent combination of education and experience
  • 10+ years of relevant experience
  • Six Sigma Black Belt Certification
  • ITIL 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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