Talent.com
Program Manager, Healthcare Services - Clinical Systems

Program Manager, Healthcare Services - Clinical Systems

Molina HealthcareRexburg, ID, United States
3 hours ago
Job type
  • Full-time
Job description

Job Summary

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.
  • Six sigma certification
  • Experience with Agile Methodology
  • Experience with Epic
  • To all current Molina employees : If you are interested in applying for this position, please apply through the Internal Job Board.

    Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M / F / D / V

    Pay Range : $77,969 - $171,058 / ANNUAL

  • Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.
  • Create a job alert for this search

    Clinical Program Manager • Rexburg, ID, United States

    Related jobs
    • Promoted
    Customs and Border Protection Officer

    Customs and Border Protection Officer

    U.S. Customs and Border ProtectionLincoln, ID, United States
    Full-time
    Customs and Border Protection (CBP) offers those interested in a career in law enforcement an exceptional opportunity to work with an elite team of highly trained professionals whose camaraderie, p...Show moreLast updated: 30+ days ago
    • Promoted
    Healthcare Services Operations Support Auditor

    Healthcare Services Operations Support Auditor

    Molina HealthcareRexburg, ID, United States
    Full-time
    Provides support for non-clinical healthcare services auditing activities.Responsible for performing audits for non-clinical functional areas in alignment with regulatory requirements - ensuring qu...Show moreLast updated: 14 days ago
    • Promoted
    Transition of Care Coach (RN) (Pacific Business hours)

    Transition of Care Coach (RN) (Pacific Business hours)

    Molina HealthcareRexburg, ID, United States
    Full-time
    Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, inc...Show moreLast updated: 17 days ago
    • Promoted
    Care Review Clinician, Applied Behavioral Analysis (ABA)

    Care Review Clinician, Applied Behavioral Analysis (ABA)

    Molina HealthcareRexburg, ID, United States
    Full-time
    Provides support for member clinical review processes specific to applied behavioral analysis (ABA) services.Responsible for verifying that behavioral health services are medically necessary and al...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse - RN - Behavioral Health - $1730.52 / Week

    Travel Nurse - RN - Behavioral Health - $1730.52 / Week

    TRS HealthcareIdaho Falls, ID, US
    Full-time
    TRS Healthcare is seeking an experienced Behavioral Health Registered Nurse for an exciting Travel Nursing job in Idaho Falls, ID. Shift : 3x12 hr nights Start Date : 11 / 03 / 2025 Duration : 13 weeks Pay...Show moreLast updated: 5 days ago
    • Promoted
    Travel Nurse - RN - Behavioral Health - $1529 / Week

    Travel Nurse - RN - Behavioral Health - $1529 / Week

    Fusion Medical StaffingIdaho Falls, ID, US
    Full-time
    Fusion Medical Staffing is seeking an experienced Behavioral Health Registered Nurse for an exciting Travel Nursing job in Idaho Falls, ID. Shift : Inquire Start Date : 11 / 03 / 2025 Duration : 13 weeks P...Show moreLast updated: 5 days ago
    • Promoted
    Travel Physical Therapist (PT) - $1,820 to $3,000 per week in Rexburg, ID

    Travel Physical Therapist (PT) - $1,820 to $3,000 per week in Rexburg, ID

    AlliedTravelCareersRexburg, ID, US
    Full-time
    AlliedTravelCareers is working with CompHealth to find a qualified Physical Therapist (PT) in Rexburg, Idaho, 83440!.Though your CompHealth recruiter will be your single point of contact, they are ...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Program Manager, Healthcare Services - Clinical Systems

    Program Manager, Healthcare Services - Clinical Systems

    Molina HealthcareIdaho Falls, ID, United States
    Full-time
    Provides subject matter expertise and leadership to healthcare services function - providing support for project / program / process design, execution, evaluation and support, and ensuring compliance w...Show moreLast updated: 3 hours ago
    • Promoted
    Director, Clinical Systems

    Director, Clinical Systems

    Molina HealthcareIdaho Falls, ID, United States
    Full-time
    Leads and directs a team supporting clinical systems.Responsible for provision of product ownership of clinical applications including design, development, implementation, and oversight of technolo...Show moreLast updated: 7 days ago
    • Promoted
    Travel Nurse RN - Behavioral Health - $1,730 per week in Idaho Falls, ID

    Travel Nurse RN - Behavioral Health - $1,730 per week in Idaho Falls, ID

    TravelNurseSourceIdaho Falls, ID, US
    Full-time
    TravelNurseSource is working with TRS Healthcare to find a qualified Behavioral Health RN in Idaho Falls, Idaho, 83404!.Registered Nurse - Behavioral Health. TRS Healthcare is seeking a Registered N...Show moreLast updated: 3 days ago
    • Promoted
    Case Manager, LTSS

    Case Manager, LTSS

    Molina HealthcareIdaho Falls, ID, United States
    Full-time
    Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, inc...Show moreLast updated: 30+ days ago
    • Promoted
    Care Review Clinician, Inpatient Review (RN)

    Care Review Clinician, Inpatient Review (RN)

    Molina HealthcareIdaho Falls, ID, United States
    Full-time
    JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes.Responsible for verifying that services are medically necessary and align with established clini...Show moreLast updated: 17 days ago
    • Promoted
    Director, Clinical Operations

    Director, Clinical Operations

    Molina HealthcareIdaho Falls, ID, United States
    Full-time
    The Director, Clinical Operations is responsible for the clinical operations within the Clinical Contact Center team.Directs all Clinical Contact Center operations. Implements direction and performa...Show moreLast updated: 17 days ago
    • Promoted
    Care Manager - Idaho

    Care Manager - Idaho

    Molina HealthcareIdaho Falls, ID, United States
    Full-time
    For this position we are seeking a Care Manager who lives in Idaho.Care manager will support Idaho Medicaid.This position will have a case load and manage members enrolled in this program.We are lo...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse RN - Behavioral Health - $1,914 per week

    Travel Nurse RN - Behavioral Health - $1,914 per week

    HealthTrust Workforce Solutions HCAIdaho Falls, ID, United States
    Full-time
    HealthTrust Workforce Solutions HCA is seeking a travel nurse RN Behavioral Health for a travel nursing job in Idaho Falls, Idaho. Job Description & Requirements.About HealthTrust Workforce Solution...Show moreLast updated: 1 day ago
    • Promoted
    National Reactor Innovation Center Technical Program Manager

    National Reactor Innovation Center Technical Program Manager

    Idaho National LaboratoryIdaho Falls, ID, US
    Full-time
    The National Reactor Innovation Center at Idaho National Laboratory is hiring a Technical Program Manager to work in our Demonstration Infrastructure and Partnerships. Our team works a 9x80 schedule...Show moreLast updated: 2 days ago
    • Promoted
    Clinical Growth Manager Idaho Falls, ID

    Clinical Growth Manager Idaho Falls, ID

    FayIdaho Falls, ID, US
    Full-time
    Clinical Growth Manager Idaho Falls, ID.Fay is a 3-sided AI platform redefining preventative care with a b2b2c business in a box. We're one of the fastest growing companies in tech and the fastest ...Show moreLast updated: 30+ days ago
    • Promoted
    Border Patrol Agent

    Border Patrol Agent

    U.S. Customs and Border ProtectionParker, ID, United States
    Full-time
    Customs and Border Protection (CBP) offers those interested in a career in law enforcement an exceptional opportunity to work with an elite team of highly trained professionals whose camaraderie, p...Show moreLast updated: 30+ days ago
    • Promoted
    Customs and Border Protection Officer - Experienced (GS9)

    Customs and Border Protection Officer - Experienced (GS9)

    U.S. Customs and Border ProtectionSugar City, ID, United States
    Full-time
    Customs and Border Protection (CBP) offers those interested in a career in law enforcement an exceptional opportunity to work with an elite team of highly trained professionals whose camaraderie, p...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    RN Carceral Care Manager Remote

    RN Carceral Care Manager Remote

    Molina HealthcareIdaho Falls, ID, United States
    Remote
    Full-time
    Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, inc...Show moreLast updated: 3 hours ago