Talent.com
No longer accepting applications
Program Manager, Healthcare Services - Clinical Systems

Program Manager, Healthcare Services - Clinical Systems

Molina HealthcareDecatur, GA, United States
11 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 • Decatur, GA, United States

    Related jobs
    • Promoted
    • New!
    Program Manager, Healthcare Services - Clinical Systems

    Program Manager, Healthcare Services - Clinical Systems

    Molina HealthcareLawrenceville, GA, United States
    Full-time
    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...Show moreLast updated: 4 hours ago
    • Promoted
    Travel Nurse - RN - ICU - Intensive Care Unit - $1677.96 / Week

    Travel Nurse - RN - ICU - Intensive Care Unit - $1677.96 / Week

    FlexCareLithonia, GA, US
    Full-time
    FlexCare is seeking an experienced Intensive Care Unit Registered Nurse for an exciting Travel Nursing job in Lithonia, GA. Shift : 3x12 hr days Start Date : 11 / 10 / 2025 Duration : 13 weeks Pay : $1677.W...Show moreLast updated: 3 days ago
    • Promoted
    Travel Physical Therapist - $1,925 per week

    Travel Physical Therapist - $1,925 per week

    ADN HealthcareAustell, GA, United States
    Full-time +1
    ADN Healthcare is seeking a travel Physical Therapist for a travel job in Austell, Georgia.Job Description & Requirements. ADN Healthcare has thousands of contract and direct hire positions availabl...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Outpatient Physical Therapist - $2,130 per week

    Travel Outpatient Physical Therapist - $2,130 per week

    TheraEx TherapyLocust Grove, GA, United States
    Full-time
    TheraEx Therapy is seeking a travel Outpatient Physical Therapist for a travel job in Locust Grove, Georgia.Job Description & Requirements. Physical Therapist - Urgent Need!.Length of Contract : 13 w...Show moreLast updated: 11 days ago
    • Promoted
    Manager, Healthcare Services; Behavioral Health (Remote GA)

    Manager, Healthcare Services; Behavioral Health (Remote GA)

    Molina HealthcareLawrenceville, GA, United States
    Remote
    Full-time
    This position will offer remote work flexibility, however, the selected candidate must reside in the state of Georgia.JOB DESCRIPTION Job Summary Leads and manages multidisciplinary team of health...Show moreLast updated: 13 days ago
    • Promoted
    Nurse Manager- Outpatient Oncology Clinic-Marietta

    Nurse Manager- Outpatient Oncology Clinic-Marietta

    Wellstar Health Systems, Inc.Austell, GA, US
    Full-time
    How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission i...Show moreLast updated: 30+ days ago
    • Promoted
    Physical Therapist PRN

    Physical Therapist PRN

    Wellstar Health Systems, Inc.Griffin, GA, United States
    Full-time
    How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission i...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Outpatient Orthopedic Physical Therapist

    Travel Outpatient Orthopedic Physical Therapist

    Skyline Med Staff AlliedLocust Grove, GA, US
    Full-time
    Skyline Med Staff Allied is seeking a travel Physical Therapist for a travel job in Locust Grove, Georgia.Job Description & Requirements. Join the Top- Rated Travel Healthcare Team!.Skyline Med ...Show moreLast updated: 14 days ago
    • Promoted
    Travel Physical Therapist (PT)

    Travel Physical Therapist (PT)

    Fusion Medical StaffingLocust Grove, GA, US
    Full-time
    Travel Physical Therapist (PT).Facility in Locust Grove, Georgia.Fusion Medical Staffing is seeking a skilled Physical Therapist for a 13-week travel assignment in Locust Grove, Georgia.As a member...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Physical Therapist - $2,006 per week

    Travel Physical Therapist - $2,006 per week

    PRIDE HealthLocust Grove, GA, United States
    Full-time
    PRIDE Health is seeking a travel Physical Therapist for a travel job in Locust Grove, Georgia.Job Description & Requirements. A Physical Therapist (PT) assesses and develops treatment plans for pati...Show moreLast updated: 12 days ago
    • Promoted
    Program Manager

    Program Manager

    RIT SolutionsAtlanta, GA, US
    Full-time
    Program Manager - Remote Job Description.The Premium Billing and Reconciliation Program Manager will support group and individual health plan premium billing and reconciliation processes, ensuring ...Show moreLast updated: 30+ days ago
    • Promoted
    RN - IMCU, PRN, Days

    RN - IMCU, PRN, Days

    Piedmont Newnan HospitalNewnan, GA, United States
    Full-time
    The staff nurse provides nursing care to patients from birth through the lifecycle utilizing nursing processes to assess, plan, implement, and evaluate the care for patients.He / she functions within...Show moreLast updated: 27 days ago
    • Promoted
    Travel Physical Therapist

    Travel Physical Therapist

    Go HealthcareLocust Grove, GA, US
    Full-time
    Go Healthcare is seeking a travel Physical Therapist for a travel job in Locust Grove, Georgia.Job Description & Requirements. Pay package is based on 8 hour shifts and 40 hours per week (subjec...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Physical Therapist - Outpatient Orthopedics - $2,006 per week

    Travel Physical Therapist - Outpatient Orthopedics - $2,006 per week

    Coast Medical ServiceLocust Grove, GA, United States
    Full-time
    Coast Medical Service is seeking a travel Physical Therapist for a travel job in Locust Grove, Georgia.Job Description & Requirements. Coast Medical Service is a nationwide travel nursing & allied h...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Physical Therapist - $1,988 per week

    Travel Physical Therapist - $1,988 per week

    Connected Health CareLocust Grove, GA, United States
    Full-time +2
    Connected Health Care is seeking a travel Physical Therapist for a travel job in Locust Grove, Georgia.Job Description & Requirements. Competitive WEEKLY Pay for Qualified Candidates!.Connected Heal...Show moreLast updated: 12 days ago
    • Promoted
    • New!
    Clinical Manager - MedSurg

    Clinical Manager - MedSurg

    Piedmont Fayette HospitalWoolsey, GA, US
    Full-time
    Description : RESPONSIBLE FOR : Administrative and operational responsibility for assigned departments, including management of cost and finance, human resources, operations, quality of care and clin...Show moreLast updated: 10 hours ago
    • Promoted
    Physical Therapist (PT)

    Physical Therapist (PT)

    Powerback RehabilitationPalmetto, GA, United States
    Full-time +1
    FULL-TIME PHYSICAL THERAPIST (PT).At Powerback, we're on a mission to improve lives.As the leader in physical, occupational, speech, and respiratory therapies, we help older adults stay active and ...Show moreLast updated: 1 day ago
    • Promoted
    Travel Physical Therapist (PT) - $1,765 per week in Locust Grove, GA

    Travel Physical Therapist (PT) - $1,765 per week in Locust Grove, GA

    AlliedTravelCareersLocust Grove, GA, US
    Full-time
    AlliedTravelCareers is working with Triage Staffing LLC to find a qualified Physical Therapist (PT) in Locust Grove, Georgia, 30248!. Travel Rehab : Physical Therapy Locust Grove.Location : Lo...Show moreLast updated: 19 days ago
    • Promoted
    Project Manager

    Project Manager

    CyberCodersSmyrna, GA, US
    Full-time
    We have been in business in the Atlanta market for over 75 years, and we are leaders in the public utility and heavy construction space. We are currently looking to hire a Project Manager with Linea...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Outpatient Physical Therapist - $2,329 per week

    Travel Outpatient Physical Therapist - $2,329 per week

    TheraEx TherapyLocust Grove, GA, United States
    Full-time
    TheraEx Therapy is seeking a travel Outpatient Physical Therapist for a travel job in Locust Grove, Georgia.Job Description & Requirements. Physical Therapist - Urgent Need!.Length of Contract : 13 w...Show moreLast updated: 30+ days ago