Program Manager - Remote (MI)

Community Reinvestment And In Lieu Of Service Billing Strategy Manager

In this role you will be responsible for ensuring Molina Healthcare of Michigan meets its Community Reinvestment obligations under the Medicaid and HIDE SNP contracts with the State of Michigan while supporting the needs of the communities served across Molina's Michigan footprint. You will lead strategic approaches and partnerships to maximize impact and take an active role in understanding the community health related social needs policy landscape to analyze, develop, and implement new requirements. Your contributions will be instrumental in making business decisions that aim to improve the health and wellbeing of Michigan residents. The ideal candidate will be an experienced leader who has built and maintained a professional network of Michigan-based healthcare and non-profit community contacts for the purpose of establishing and expanding Molina's partnerships with Community-Based Organizations. You are collaborative, working across health plan departments to improve overall knowledge of health related social needs, partnerships and relationships within the State of Michigan. This role utilizes market research and analysis to increase community engagement in key business decisions. Provides support to Molina functional areas through program management, including policy, workflow and process documentation, management of program controls, vendor practices, budgets, governance frameworks, playbooks and best practices, and champion networks, as applicable.

Job Duties

• Works closely with the Chief Medical Officer and Director of Population Health to develop and execute the Health Plan's Community Reinvestment and In Lieu of Service billing strategies
• Contributes to the development, implementation, and evaluation of the relationship target list for each region; plans, coordinates and attends meetings with key stakeholders in each assigned community.
• Serve as subject matter expert for using quality improvement approaches to successfully implement health-related social needs and health equity programs, in adherence with regulatory requirements
• Leads team in the development of relationships with key providers, Community Based Organizations (CBOs), Faith Based Organizations (FBOs), healthcare facilities and organizations and School Based Organizations (SBOs) and how Molina can create effective partnerships with their organizations to maximize quality services to meet member's needs
• Researches state policy and develops programs and reporting that meet the approval of State / Federal guidelines for all community reinvestment and ILOS billing requirements
• Demonstrates a strong sense of urgency by responding immediately to escalated issues and rapidly changing priorities.
• Demonstrates thorough understanding of Molina's product lines, Medicaid, Medicare SNP, Marketplace, MMP, etc.
• Develops strategy to evaluate the value of key partnerships to inform the most impactful partnerships for continued collaboration.

Required Knowledge / Skills / Abilities

Required Education : Bachelor's Degree or equivalent experience. Preferred Education : Master's Degree in Public Health, Public Policy or Healthcare Administration preferred.