Talent.com
Program Manager, Healthcare Services - Clinical Program Design
Program Manager, Healthcare Services - Clinical Program DesignMolina Healthcare • Jacksonville, FL, US
Program Manager, Healthcare Services - Clinical Program Design

Program Manager, Healthcare Services - Clinical Program Design

Molina Healthcare • Jacksonville, FL, US
[job_card.variable_days_ago]
[job_preview.job_type]
  • [job_card.full_time]
[job_card.job_description]

Healthcare Services Expert

Provides subject matter expertise and leadership to healthcare services function - providing support for project / program / process design, execution, evaluation and support, and ensuring compliance with regulatory and internal standards, practices, policies and contractual commitments. Contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

  • Collaboratively plans and executes internal healthcare services projects and programs involving department or cross-functional teams of subject matter experts - delivering products from the design process to completion.
  • Provides ongoing communication related to program goals, evaluation and support to ensure compliance with standardized protocols and processes.
  • May engage and oversee the work of external vendors.
  • Focuses on process improvement, organizational change management, program management and other processes relative to business needs.
  • Serves as a subject matter expert and leads healthcare services programs to meet critical needs.
  • Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements.
  • Conducts quality audits to assess healthcare services staff educational needs and service quality, and implements quality initiatives within the department as appropriate.
  • Creates business requirements documents (BRDs), test plans, requirements traceability matrix (RTMs), user training materials and other related business documents.

Required Qualifications

  • At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of the following areas : utilization management, care management, care transitions, behavioral health, or equivalent combination of relevant education and experience.
  • Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC) or Licensed Marriage and Family Therapist (LMFT). Clinical licensure and / or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
  • Strong analytical and problem-solving skills.
  • Strong organizational and time-management skills.
  • Ability to work in a cross-functional, professional environment.
  • Experience working within applicable state, federal, and third-party regulations.
  • Strong verbal and written communication skills.
  • Microsoft Office suite / applicable software program proficiency, and ability to navigate online portals and databases.
  • Preferred Qualifications

  • Certified Case Manager (CCM), Certified Professional in Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care or management certification.
  • Leadership experience.
  • Medicaid / Medicare population experience.
  • Pay Range : $80,168 - $171,058 / ANNUAL

  • Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.
  • Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M / F / D / V

    [job_alerts.create_a_job]

    Program Manager Healthcare Services Clinical Program Design • Jacksonville, FL, US

    [internal_linking.similar_jobs]
    Clinical Lead RN - Acute Rehab

    Clinical Lead RN - Acute Rehab

    Ascension • Jacksonville, FL, US
    [job_card.full_time]
    Various health insurance options & wellness plans.Retirement benefits including employer match plans.Long-term & short-term disability. Employee assistance programs (EAP).Parental leave & adoption a...[show_more]
    [last_updated.last_updated_1_hour] • [promoted] • [new]
    Care Manager - Multiple Openings in FL (RN, LBSW, LLMSW, LMSW)

    Care Manager - Multiple Openings in FL (RN, LBSW, LLMSW, LMSW)

    Molina Healthcare • Jacksonville, FL, US
    [job_card.full_time]
    Provides support for care management / care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum.Strives to ensure...[show_more]
    [last_updated.last_updated_variable_hours] • [promoted] • [new]
    Care Review Clinician (RN)

    Care Review Clinician (RN)

    Molina Healthcare • Jacksonville, FL, US
    [job_card.full_time]
    JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes.Responsible for verifying that services are medically necessary and align with established clini...[show_more]
    [last_updated.last_updated_variable_hours] • [promoted] • [new]
    Associate Center Clinical Director - Cedar Hills, Jacksonville

    Associate Center Clinical Director - Cedar Hills, Jacksonville

    ChenMed • Jacksonville, FL, United States
    [job_card.full_time]
    We’re changing lives every day.For both our patients and our team members.Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with ...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Clinical Manager

    Clinical Manager

    ChenMed • Jacksonville, FL, United States
    [job_card.full_time]
    We’re changing lives every day.For both our patients and our team members.Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with ...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Regional Manager Continuum of Care

    Regional Manager Continuum of Care

    Premier • Jacksonville, FL, US
    [job_card.full_time]
    Regional Manager Continuum of Care.The Regional Manager is a field-based sales role requiring frequent client interaction and up to three days of travel per week (approximately 5070%) within an ass...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Director Clinical Labs

    Director Clinical Labs

    UVA Health • Jacksonville, FL, US
    [job_card.full_time]
    RELOCATE TO VIRGINIA OPPORTUNITY.Join our esteemed team of healthcare professionals committed to advancing healthcare through cutting-edge research, comprehensive training, and compassionate care.U...[show_more]
    [last_updated.last_updated_variable_hours] • [promoted] • [new]
    Travel RN Case Manager

    Travel RN Case Manager

    LeaderStat • Jacksonville, FL, US
    [job_card.full_time] +1
    LeaderStat is seeking a travel nurse RN Case Management for a travel nursing job in Jacksonville, Florida.Job Description & Requirements. LPNT IRF Travel - RN CASE MANAGER - JACKSONVILLE REHAB H...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Co-Responder Case Manager

    Co-Responder Case Manager

    Mental Health Resource Center • Jacksonville, FL, US
    [job_card.full_time]
    Medical, Dental, and Vision Insurance.Mental Health Resource Center is a not-for-profit Florida corporation that provides a wide range of mental health and behavioral health care services to the co...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Project Manager - Healthcare - Remote

    Project Manager - Healthcare - Remote

    AssistRx • Jacksonville, FL, US
    [filters.remote]
    [job_card.full_time]
    The Project Manager will be a member of the PMO Team, reporting to the Director of Program Management.The PMO Team leads client software implementation projects and works closely with the Product M...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Travel RN Case Manager

    Travel RN Case Manager

    Host Healthcare • Jacksonville, FL, US
    [job_card.full_time]
    Host Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Jacksonville, Florida.Job Description & Requirements. Pay package is based on 8 hour shifts and 40 hours ...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Manager - Health Actuary

    Manager - Health Actuary

    Smith Hanley Associates • Jacksonville, FL, US
    [job_card.full_time]
    Position : Manager - Health Actuary.Salary : $130,000-150,000 + Bonus.Relocation is required for this opportunity • • • •. This opportunity is for an experienced health actuary supporting Medicare Advant...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Associate Center Clinical Director

    Associate Center Clinical Director

    ChenMed • Jacksonville, FL, United States
    [job_card.full_time]
    We’re changing lives every day.For both our patients and our team members.Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with ...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Clinical Liaison

    Clinical Liaison

    Lifepoint Health® • Jacksonville, FL, US
    [job_card.part_time]
    North Florida Rehabilitation Hospital,.In your role, you’ll support those in our facilities who are interfacing and providing care to our patients and community members.We believe that our co...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Clinical Lead RN - Stepdown

    Clinical Lead RN - Stepdown

    Ascension • Jacksonville, FL, US
    [job_card.full_time]
    Various health insurance options & wellness plans.Retirement benefits including employer match plans.Long-term & short-term disability. Employee assistance programs (EAP).Parental leave & adoption a...[show_more]
    [last_updated.last_updated_1_hour] • [promoted] • [new]
    Clinical Operations Director (BCBA)

    Clinical Operations Director (BCBA)

    InBloom Autism Services • Jacksonville, FL, US
    [job_card.full_time]
    To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.The requirements listed below are representative of the knowledge, skill, and / or ability r...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Travel RN Case Manager

    Travel RN Case Manager

    LifePoint • Jacksonville, FL, US
    [job_card.full_time]
    LifePoint is seeking a travel nurse RN Case Management for a travel nursing job in Jacksonville, Florida.Job Description & Requirements. North Florida Rehabilitation Hospital is a state-of-the-a...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Director, Oncology Program Management

    Director, Oncology Program Management

    BeiGene • Jacksonville, FL, US
    [job_card.full_time]
    Oncology Clinical Development Program Manager.BeOne continues to grow at a rapid pace with challenging and exciting opportunities for experienced professionals. When considering candidates, we look ...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]