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.
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 related 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.
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, business operating model, 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.
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.
Molina Healthcare offers competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Program Manager, Healthcare Services • Mesa, AZ, United States
Registered Nurse (RN) | Case Manager.United Health Care Staffing, Inc.Competitive weekly pay (inquire for details) .TravelNurseSource is working with United Health Care Staffing, Inc.Case Manager R... Show more
Job Type: Full Time Regular Department: Revenue/Internal Audit.Tribal Driving Permit Required: Yes.DISTINGUISHING FEATURES OF THE CLASS:.The Internal Auditor (Healthcare) performs program and compl... Show more
Responsibilities The primary responsibility of this position is to read meters and record consumption of the water used, cleaning of meter boxes, and removal of vegetation impeding access to meters... Show more
Right At Home, In-Home Care & Assistance.Right at Home, In-Home Care & Assistance is seeking to hire CNAs and Private Duty In Home Non Medical Aids to join a dynamic care team providing clinical ex... Show more
Forbes names Mesa Public Schools in their list of Best Employers in Arizona for multiple years.East Valley Tribune names Mesa Public Schools as Best Place to Work in East Valley for multiple years.... Show more
The Management Trainee position's primary responsibility is to fulfill our mission statement, "to create the most enjoyable shopping experience possible for our Guests.Additionally, Management Trai... Show more
Behavioral Health Technician (BHT) - Day Shift Important - Please Read Before Applying Applicants cannot be considered for hire or interview unless they already have the following:In-person CPR &am... Show more
A thriving practice in the suburbs of Phoenix is seeking a radiation oncologist to join our team.This is an exciting opportunity to join an organization, with Oncology/Hematology, Surgical Oncology... Show more
CG ARIZOLA - CASA GRANDE, AZ 85122.Position Type Full-time Job Shift 9:00am-6:00pm Monday-Friday.Lead Medical Assistant Make a Difference Every Day!.Are you passionate about helping others and thr... Show more
Agave Ridge Behavioral Hospital is seeking a full time Behavioral Health Associate at our state of the art hospital in Mesa, AZ.We are changing how care is delivered by bringing together people lik... Show more
Now offering DAILY PAY for select positions!.Take advantage of this unique opportunity to learn the fundamentals of quality home care and deliver life-changing service to your clients.As an Arcadia... Show more
OB Hospitalist - Site Director.As part of the Ob Hospitalist clinical team, an Ob Hospitalist embraces delivering a quality OB Hospitalist program Value-Based culture.Program Operations to ensure q... Show more
AlliedTravelCareers is working with MedPro Healthcare Staffing to find a qualified Physical Therapist (PT) in Casa Grande, Arizona, 85122!.Joint Commission-certified staffing agency, is seeking a q... Show more
Join one of Arizona's leading diagnostic labs at Sonora Quest, where your work directly supports life-saving medical testing and patient care.Whether you're beginning your lab career or bringing ex... Show more
Under the direction of the Clinical Coordinator, the Team Specialist coordinates, monitors, and provides direct services to members and families at the clinic and in the community, including case m... Show more
The Auditor I is a contributor to the Audits department's work that spans the broad spectrum of healthcare performance measurement projects at HSAG.Driven by intellectual curiosity and a passion fo... Show more
Surrogacy Opportunity Starts at $67K-$87K+ with a $1,250 Pre-Screening Bonus.Looking for a high-paying opportunity with real support and no upfront costs?.Become a Surrogate and earn up to.All exp... Show more
Customs and Border Protection Officer (CBPO).Customs and Border Protection (CBP) offers those interested in a career in law enforcement an exceptional opportunity to work with an elite team of high... Show more
DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day.As a Dasher, you’ll stay busy with a variety o... Show more
Certified Occupational Therapist Assistant (COTA) - Home Health/ Clinic.The SPEAK Center for Language and Learning is a renowned multidisciplinary pediatric rehabilitative clinic committed to provi... Show more
){kind=logo}
