Molina Healthcare Inc. Logo

Molina Healthcare Inc.

Senior Program Manager (Network Adequacy) - Remote

Posted 2 Hours Ago
Be an Early Applicant
In-Office or Remote
Hiring Remotely in United States
Senior level
In-Office or Remote
Hiring Remotely in United States
Senior level
Lead and manage programs delivering CMS/HPMS submissions and network adequacy activities. Coordinate cross-functional teams and vendors, oversee regulatory documentation in Inovarre, create business requirements, test plans, and training materials, and drive process improvements while monitoring schedules, budgets, and program delivery.
The summary above was generated by AI

JOB DESCRIPTION

Job Summary

Responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. Plans and directs schedules as well as project budgets. Monitors the project from inception through delivery. May engage and oversee the work of external vendors. Assigns, directs, and monitors system analysis 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 CMS/HPMS submission activities and ongoing monitoring, including Health Service Delivery (HSD) tables and Exception Requests associated with Service Area Expansions (SAE) and triennial network adequacy reviews.
  • Coordinates with Product and Markets teams to ensure accurate and timely updates on expansion counties for Notices of Intent to Apply (NOIAs), Notices of Intent to Deny (NOIDs), and service area withdrawals.
  • Conducts regulatory documentation review within Inovarre and ensures alignment with CMS regulatory requirements, including updated network adequacy guidance, templates, and supporting documentation.
  • 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.
  • Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements. 
  • Works with operational leaders within the business to provide recommendations on opportunities for process improvements.
  • Creates business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations.
  • 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


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.


Similar Jobs

30 Minutes Ago
Remote
California, USA
76K-200K Annually
Junior
76K-200K Annually
Junior
Artificial Intelligence • Healthtech • Machine Learning • Natural Language Processing • Biotech • Pharmaceutical
Pharmaceutical sales role promoting migraine therapy within a defined territory. Drives sales through in-person and virtual HCP engagement, develops and executes territory call plans, leverages analytics and approved clinical information, collaborates cross-functionally, and completes administrative and compliance requirements.
2 Hours Ago
In-Office or Remote
140K-190K Annually
Mid level
140K-190K Annually
Mid level
Greentech • Hardware • Internet of Things • Machine Learning • Software • Business Intelligence • Agriculture
Drive new business and customer success across SE Wyoming by prospecting, performing in-field sales and onboarding, expanding accounts, meeting sales targets, gathering field feedback, collaborating with support, and representing Halter at industry events. Frequent travel and hands-on ranch work required.
2 Hours Ago
Remote or Hybrid
106K-160K Annually
Senior level
106K-160K Annually
Senior level
Cloud • Fintech • Software • Business Intelligence • Consulting • Financial Services
Manage complex tax returns and consulting services for partnership clients, evaluate partnership agreements, mentor staff, and enhance client relationships.
Top Skills: Tax-Related Software

What you need to know about the Charlotte Tech Scene

Ranked among the hottest tech cities in 2024 by CompTIA, Charlotte is quickly cementing its place as a major U.S. tech hub. Home to more than 90,000 tech workers, the city’s ecosystem is primed for continued growth, fueled by billions in annual funding from heavyweights like Microsoft and RevTech Labs, which has created thousands of fintech jobs and made the city a go-to for tech pros looking for their next big opportunity.

Key Facts About Charlotte Tech

  • Number of Tech Workers: 90,859; 6.5% of overall workforce (2024 CompTIA survey)
  • Major Tech Employers: Lowe’s, Bank of America, TIAA, Microsoft, Honeywell
  • Key Industries: Fintech, artificial intelligence, cybersecurity, cloud computing, e-commerce
  • Funding Landscape: $3.1 billion in venture capital funding in 2024 (CED)
  • Notable Investors: Microsoft, Google, Falfurrias Management Partners, RevTech Labs Foundation
  • Research Centers and Universities: University of North Carolina at Charlotte, Northeastern University, North Carolina Research Campus

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account