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

Program Manager, Healthcare Services - Clinical Program Design

Molina Healthcare • Miami, 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 • Miami, FL, US

    [internal_linking.similar_jobs]
    Clinical Program Coordinator

    Clinical Program Coordinator

    University of Miami • Miami, FL, US
    [job_card.full_time]
    If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click.Workday to use the internal application process. To learn how to apply for a faculty or staff posit...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Associate Nurse Manager, Operating Room (Neuro)

    Associate Nurse Manager, Operating Room (Neuro)

    Jackson Health System • Miami, FL, US
    [job_card.full_time]
    Department : Jackson Memorial Hospital - Main Operating Room Administration.Address : 1611 NW 12th Ave, Miami, Florida, 33136. Shift details : Full-Time, Days.Jackson Memorial Hospital is the flagship ...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Clinical Resource Director - Healthcare

    Clinical Resource Director - Healthcare

    HCA Florida Kendall Hospital • Miami, FL, US
    [job_card.full_time] +1
    This position is incentive eligible.Do you want to join an organization that invests in you as a Clinical Resource Director? At HCA Florida Kendall Hospital, you come first.HCA Healthcare has commi...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Associate Professor of Clinical - Cardiovascular (Fellowship Program Director)

    Associate Professor of Clinical - Cardiovascular (Fellowship Program Director)

    HealthEcareers - Client • Miami, FL, USA
    [job_card.full_time]
    The University of Miami Health System is initiating a search for a Cardiovascular Fellowship Program Director.Oversee and manage the fellowship program that trains and educates physicians specializ...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Senior Director, Product Management for Core Health Plan

    Senior Director, Product Management for Core Health Plan

    Blue Shield of CA • Miami, FL, United States
    [job_card.full_time]
    Director of Product Management for Core Health Plan is responsible for owning the strategy, outcomes, and technology enablement for core health plan offerings. This includes claims processing, netwo...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Associate Center Clinical Director

    Associate Center Clinical Director

    ChenMed • Miami, FL, US
    [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]
    Program Director

    Program Director

    Gallagher • Miami, FL, United States
    [job_card.full_time]
    This role is integral to managing insurance programs, overseeing staff, and ensuring exceptional client service.The Program Director will serve as the trusted advisor and relationship lead for our ...[show_more]
    [last_updated.last_updated_1_day] • [promoted]
    Clinical Program Manager - Blood Bank

    Clinical Program Manager - Blood Bank

    The University of Miami • Miami, FL, United States
    [job_card.full_time]
    If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a facu...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Care Manager, LTSS (Must Reside In Idaho)

    Care Manager, LTSS (Must Reside In Idaho)

    Molina Healthcare • MIAMI, FL, United States
    [job_card.full_time]
    Provides support for care management / care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member ca...[show_more]
    [last_updated.last_updated_variable_hours] • [promoted] • [new]
    Cardiovascular Fellowship Program Director in Miami, Florida

    Cardiovascular Fellowship Program Director in Miami, Florida

    University of Miami Miller School of Medicine • Miami, FL, US
    [job_card.full_time]
    The University of Miami Health System is initiating a search for a Cardiovascular Fellowship Program Director.Oversee and manage the fellowship program that trains and educates physicians specializ...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Senior Director, Core Health Plan Product & AI Strategy

    Senior Director, Core Health Plan Product & AI Strategy

    Blue Shield of CA • Miami, FL, United States
    [job_card.full_time]
    A leading health insurance provider is seeking a Sr.Director of Product Management for Core Health Plan in Miami.This role involves owning the product strategy and outcomes for core offerings, ensu...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Program Manager

    Program Manager

    Aspen Medical • Miami, FL, US
    [job_card.full_time]
    Aspen Medical has an exciting opportunity for PMs to partner with us in providing quality medical care to patients within a transitional Corrections setting. PMs, alongside fellow team members, will...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Associate Professor of Clinical - Medicine, Cardiology : Invasive Interventional

    Associate Professor of Clinical - Medicine, Cardiology : Invasive Interventional

    University of Miami - UHealth • Miami, US
    [job_card.full_time]
    The University of Miami's Cardiovascular Division, Department of Medicine is seeking an experienced and visionary Medical Director to lead the development and expansion of the Structural Heart Dise...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Clinical Nutrition Manager

    Clinical Nutrition Manager

    Compass Group USA • Miami, FL, United States
    [job_card.full_time]
    Take the next step in your career with Morrison Living as a Clinical Nutrition Manager!.Miami Jewish Health - Miami, FL.We go the extra mile for our Dietitians with benefits designed to support.Fin...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Sr. Clinical Program Coordinator

    Sr. Clinical Program Coordinator

    The University of Miami • Coral Gables, FL, United States
    [job_card.full_time]
    If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a facu...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Associate Professor of Clinical - Cardiovascular (Fellowship Program Director)

    Associate Professor of Clinical - Cardiovascular (Fellowship Program Director)

    University of Miami - UHealth • Miami, US
    [job_card.full_time]
    The University of Miami Health System is initiating a search for a Cardiovascular Fellowship Program Director.Oversee and manage the fellowship program that trains and educates physicians specializ...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Clinical Resource Director

    Clinical Resource Director

    HCA Florida Kendall Hospital • Miami, FL, US
    [job_card.full_time] +1
    This position is incentive eligible.Do you want to join an organization that invests in you as a Clinical Resource Director? At HCA Florida Kendall Hospital, you come first.HCA Healthcare has commi...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Associate Professor of Clinical - Medicine, Cardiology : Invasive Interventional

    Associate Professor of Clinical - Medicine, Cardiology : Invasive Interventional

    HealthEcareers - Client • Miami, FL, USA
    [job_card.full_time]
    The University of Miami's Cardiovascular Division, Department of Medicine is seeking an experienced and visionary Medical Director to lead the development and expansion of the Structural Heart Dise...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]