Senior Managed Care Operations (MCO) Project Manager

Remote Full-time
Job SummaryManages people who are responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts. The ideal candidate will be responsible for planning, executing, and delivering projects on time, within scope, and within budget. This role requires strong leadership, communication, and problem-solving skills to manage resources, mitigate risks, and ensure stakeholder satisfaction. Although a project management role, this role will be assigned some operations initiatives to lead and collaborate with other team members who are subject matter experts.Builds work breakdown structures, monitors task activities, and ensures state contract timelines are met. Monitors the project from inception through delivery. May engage and oversee the work of external vendors. Assigns, directs and monitors project teams through requirement solicitation, requirement documentation, and Sponsor approvals. Works as the liaison between the health plan and IT to ensure requirements are interpreted correctly and the development lifecycle timeline is being followed. Communicates project status through weekly reporting, project status meetings, and leadership presentations.Manages the project RACI and RAID log, project plan, and other project management tools. Knowledge/Skills/AbilitiesSkills:• Defines project scope, goals, and deliverables in collaboration with stakeholders. • Develops detailed project plans, schedules, and resource allocations. • Leads project teams, assigns tasks, and monitors progress. • Manages budgets, timelines, and project risks. • Communicates project status, issues, and milestones to stakeholders and leadership. • Ensures quality standards and compliance with company policies.• Facilitates meetings, workshops, and presentations. • Identifies and resolves project roadblocks and conflicts. • Strong analytical, organizational, and decision-making skills• Experience working with IT waterfall and agile system development lifecycle methodologiesKnowledge• Experienced in working with claims and claim configuration teams to streamline adjudication and resolve claim processing issues• Familiar with payment integrity and other bolthires recovery processes• Direct PM experience in Managed Care Operations (claims, system configuration, provider data management preferred)• Demonstrated ability to solicit and formally document business and functional requirements• Accustomed to working with IT to ensure Health Plan requirements and timelines are met• Understands Medicaid and Medicare business scenarios and appreciates the member environments we serve• Exposure to all Managed Care industry functional departmentsJob QualificationsRequired Education• Bachelor's Degree or equivalent combination of education and experienceRequired Experience• 5-7 years experience as a Health Insurance industry Project Management professionalPreferred Education• Graduate Degree or equivalent combination of education and experiencePreferred Experience• 7-9 years as Health Insurance industry Project Management professional• 3-5 years in Managed Care with emphasis on Managed Care OperationsPreferred License, Certification, Association• PMP, CAPM, PMI-ACP, PMI-PBA or Six Sigma Black/Green Belt certificationTo 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. Pay Range: $66,456 - $129,590 / ANNUAL• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Apply tot his job
Apply Now →

Similar Jobs

Operations Support Specialist – Healthcare Training – Remote/Office Hybrid (*local candidates only)

Remote Full-time

Dental Insurance Provider Network Representative

Remote Full-time

Mental Health Therapist - 1099 Contractor - United States

Remote Full-time

Mental Health Therapist for Seniors (Remote - Licensed in Florida)

Remote Full-time

Online bolthires Customer Chat Associate - Part-Time Remote Opportunity!

Remote Full-time

[Fully Remote] bolthires Customer Service – Work From Home $16-$35/hr

Remote Full-time

Remote Telemedicine Veterinarian (Evening & Weekends)

Remote Full-time

Training and Development Managers- Research Study

Remote Full-time

[Remote] Learning & Development Consultant – Remote - Performance-Based

Remote Full-time

Learning & Leadership Development Specialist - Remote Role

Remote Full-time

Task Logistics Advocate, German

Remote Full-time

Experienced Part-Time Remote Data Entry Specialist – Accurate Data Management and Administrative Support at blithequark

Remote Full-time

Remote Survey Job - Weekly Rewards

Remote Full-time

Controller

Remote Full-time

Customer Service Representative for E-Commerce - Kickstart Your Career at blithequark

Remote Full-time

(Remote) Interior Design Assistant, AutoCAD Proficient

Remote Full-time

Experienced Live Chat Support Agent – Remote Customer Service Representative for Tech Industry Leader blithequark

Remote Full-time

Experienced Remote Customer Service Representative for Healthcare Industry – Delivering Exceptional Patient Experiences through Compassionate Support and Effective Solutions

Remote Full-time

Experienced Remote Customer Service Representative and Product Tester – Flexible Part-Time Opportunity for Home-Based Work with blithequark

Remote Full-time

Remote Chat Support Representative – Customer Experience Expert at blithequark

Remote Full-time
← Back to Home