Talent.com
Program Manager, Healthcare Services - Clinical Systems

Program Manager, Healthcare Services - Clinical Systems

Molina HealthcareBeavercreek, OH, US
4 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 • Beavercreek, OH, US

    Related jobs
    • Promoted
    STNA - State Certified & Knowledgeable in Nursing Procedures and Medical Terminology

    STNA - State Certified & Knowledgeable in Nursing Procedures and Medical Terminology

    IntelyCareBlanchester, OH, US
    Full-time
    State Tested Nursing Assistant (STNA).Blanchester, Ohio, and surrounding areas, and enjoy more control over when and where you work. Our valued nursing professionals are hired with the support and d...Show moreLast updated: 4 days ago
    • Promoted
    Travel Progressive Care (Stepdown) RN

    Travel Progressive Care (Stepdown) RN

    GHR HealthcareSpringfield, OH, US
    Full-time
    GHR Healthcare is seeking a travel nurse RN PCU - Progressive Care Unit for a travel nursing job in Springfield, Ohio.Job Description & Requirements. GHR Healthcare Job ID #73838741.Pay package ...Show moreLast updated: 2 days ago
    • Promoted
    Travel Nurse RN - PCU - Progressive Care Unit

    Travel Nurse RN - PCU - Progressive Care Unit

    Host HealthcareSpringfield, OH, US
    Full-time
    Host Healthcare is seeking a travel nurse RN PCU - Progressive Care Unit for a travel nursing job in Springfield, Ohio.Job Description & Requirements. Pay package is based on 12 hour shifts and ...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse RN - PCU - Progressive Care Unit

    Travel Nurse RN - PCU - Progressive Care Unit

    Healthcare SupportSpringfield, OH, US
    Permanent
    Healthcare Support is seeking a travel nurse RN PCU - Progressive Care Unit for a travel nursing job in Springfield, Ohio. Job Description & Requirements.Healthcare Support Job ID #477692.Pay pa...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse RN - PCU - Progressive Care Unit

    Travel Nurse RN - PCU - Progressive Care Unit

    Triage StaffingSpringfield, OH, US
    Full-time
    Triage Staffing is seeking a travel nurse RN PCU - Progressive Care Unit for a travel nursing job in Springfield, Ohio.Job Description & Requirements. Travel Nursing : Progressive Care Unit Sprin...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse RN - PCU - Progressive Care Unit

    Travel Nurse RN - PCU - Progressive Care Unit

    Aequor HealthcareSpringfield, OH, US
    Full-time
    Aequor Healthcare is seeking a travel nurse RN PCU - Progressive Care Unit for a travel nursing job in Springfield, Ohio. Job Description & Requirements.All positions require at least two proven...Show moreLast updated: 30+ days ago
    • Promoted
    2026 Summer Internship - Clinical Operations Program Manager

    2026 Summer Internship - Clinical Operations Program Manager

    CareSourceDayton, OH, United States
    Full-time
    The CareSource Intern is responsible for providing support on special projects, initiatives, and specific activities which will vary by assignment. We offer a 12-week, paid summer internship program...Show moreLast updated: 27 days ago
    • Promoted
    • New!
    Program Manager, Healthcare Services - Clinical Systems

    Program Manager, Healthcare Services - Clinical Systems

    Molina HealthcareDayton, OH, US
    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: 4 hours ago
    • Promoted
    Travel Nurse RN - PCU - Progressive Care Unit

    Travel Nurse RN - PCU - Progressive Care Unit

    Planet HealthcareSpringfield, OH, US
    Full-time
    Planet Healthcare is seeking a travel nurse RN PCU - Progressive Care Unit for a travel nursing job in Springfield, Ohio. Job Description & Requirements.Planet Healthcare Job ID #73838744.Pay pa...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse RN - Post Partum

    Travel Nurse RN - Post Partum

    Host HealthcareSpringfield, OH, US
    Full-time
    Host Healthcare is seeking a travel nurse RN Post Partum for a travel nursing job in Springfield, Ohio.Job Description & Requirements. Pay package is based on 12 hour shifts and 36 hours per wee...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse RN - PCU - Progressive Care Unit

    Travel Nurse RN - PCU - Progressive Care Unit

    Anders GroupSpringfield, OH, US
    Full-time
    Anders Group is seeking a travel nurse RN PCU - Progressive Care Unit for a travel nursing job in Springfield, Ohio.Job Description & Requirements. Pay package is based on 12 hour shifts and 36 ...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse RN - PCU - Progressive Care Unit

    Travel Nurse RN - PCU - Progressive Care Unit

    LRS Healthcare - Travel NursingSpringfield, OH, US
    Permanent
    LRS Healthcare - Travel Nursing is seeking a travel nurse RN PCU - Progressive Care Unit for a travel nursing job in Springfield, Ohio. Job Description & Requirements.LRS Healthcare - Travel Nur...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse RN - Post Partum

    Travel Nurse RN - Post Partum

    Planet HealthcareSpringfield, OH, US
    Full-time
    Planet Healthcare is seeking a travel nurse RN Post Partum for a travel nursing job in Springfield, Ohio.Job Description & Requirements. Planet Healthcare Job ID #72870719.Pay package is based o...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse RN - PCU - Progressive Care Unit

    Travel Nurse RN - PCU - Progressive Care Unit

    CrossMedSpringfield, OH, US
    Full-time
    CrossMed is seeking a travel nurse RN PCU - Progressive Care Unit for a travel nursing job in Springfield, Ohio.Job Description & Requirements. At CrossMed Healthcare Staffing, we aim to create ...Show moreLast updated: 30+ days ago
    • Promoted
    Training Program Manager

    Training Program Manager

    CredenceDayton, Ohio, US
    Full-time
    Overview At Credence, we support our clients’ mission-critical needs, powered by technology.We provide cutting-edge solutions, including AI / ML, enterprise modernization, and advanced intelligence c...Show moreLast updated: 4 days ago
    • Promoted
    Travel Registered Nurse - Progressive Care / Stepdown Unit

    Travel Registered Nurse - Progressive Care / Stepdown Unit

    GHR Healthcare - Travel DivisionSpringfield, OH, US
    Full-time
    GHR Healthcare - Travel Division is seeking a travel nurse RN PCU - Progressive Care Unit for a travel nursing job in Springfield, Ohio. Job Description & Requirements.GHR Healthcare - Travel Di...Show moreLast updated: 3 days ago
    • Promoted
    • New!
    Palliative Care RN - Advanced Illness Management

    Palliative Care RN - Advanced Illness Management

    IllumiaEnon, OH, US
    Full-time +1
    We are seeking a compassionate and experienced.Advanced Illness Management (AIM) Palliative Care Team.This is a field-based position that provides in-person and telephonic care coordination, educat...Show moreLast updated: 10 hours ago
    • Promoted
    • New!
    Assistant Director of Nursing (ADON)

    Assistant Director of Nursing (ADON)

    The Laurels of Huber HeightsHUBER HEIGHTS, OH, US
    Full-time
    Assistant Director of Nursing (ADON) •Registered Nurse (RN) •.The ADON nurse acts as the educator for the facility, conducts orientation and other in-service educational programs for the nursing sta...Show moreLast updated: 15 hours ago