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

Program Manager, Healthcare Services - Clinical Systems

Molina HealthcareAthens, GA, US
9 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 • Athens, GA, US

    Related jobs
    • Promoted
    Wellness Director

    Wellness Director

    The Phoenix At Lake LanierGainesville, GA, US
    Full-time
    The Phoenix at Lake Lanier is seeking an RN / LPN to join their team as a Wellness Director!.The Wellness Director is responsible for providing overall leadership and management of the health and wel...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse RN - Home Health

    Travel Nurse RN - Home Health

    Ardor Health SolutionsMadison, GA, US
    Full-time
    Ardor Health Solutions is seeking a travel nurse RN Home Health for a travel nursing job in Madison, Georgia.Job Description & Requirements. Access to 24 / 7 telephone support during your contract...Show moreLast updated: 2 days ago
    • Promoted
    Care Review Clinician, PA (RN)

    Care Review Clinician, PA (RN)

    Molina HealthcareAthens, GA, US
    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
    Regional Home Manager

    Regional Home Manager

    Davita Inc.Athens, GA, United States
    Full-time
    S Milledge AveSte A2, Athens, Georgia, 30605-6480, United States of America.As a Regional Home Manager at DaVita, you'll be a part of a Team that values work-life balance and where your personal an...Show moreLast updated: 9 days ago
    • Promoted
    • New!
    Physical Therapist (PT) - Home Health

    Physical Therapist (PT) - Home Health

    Enhabit Home Health & HospiceGAINESVILLE, GA, US
    Full-time
    Are you in search of a new career opportunity that makes a meaningful impact? If so, now is the time to find your calling at Enhabit Home Health & Hospice. As a national leader in home-based care, E...Show moreLast updated: 15 hours ago
    • Promoted
    Director of Specialty Programs

    Director of Specialty Programs

    InsideHigherEdAthens, Georgia, United States
    Full-time
    Director of Specialty Programs.About the University of Georgia : .Since our founding in 1785, the University of Georgia has operated as Georgia’s oldest, most comprehensive, and most diversified inst...Show moreLast updated: 30+ days ago
    • Promoted
    Dialysis Clinical Manager Registered Nurse – RN

    Dialysis Clinical Manager Registered Nurse – RN

    Fresenius Medical CareGainesville, Georgia, US
    Full-time
    As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. As the facility leader, you will be part of a close-k...Show moreLast updated: 30+ days ago
    • Promoted
    Care Review Clinician (RN)

    Care Review Clinician (RN)

    Molina HealthcareAthens, GA, US
    Full-time
    Provides support for clinical member services review assessment processes.Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance p...Show moreLast updated: 7 days ago
    Transitions in Care Program Manager

    Transitions in Care Program Manager

    Medlink GeorgiaCommerce, GA, USA
    Full-time
    Quick Apply
    About Us : MedLink Georgia is a community-based nonprofit organization providing high-quality, affordable primary care to patients across Northeast Georgia. We serve a diverse population with a focus...Show moreLast updated: 4 days ago
    • Promoted
    Transition of Care Coach (RN)

    Transition of Care Coach (RN)

    Molina HealthcareAthens, GA, US
    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
    Associate Director for Adult Serving Programming

    Associate Director for Adult Serving Programming

    InsideHigherEdAthens, Georgia, United States
    Full-time
    Associate Director for Adult Serving Programming.PSO-Fanning Inst Ldership Devl.About the University of Georgia : .Since our founding in 1785, the University of Georgia has operated as Georgia’s olde...Show moreLast updated: 30+ days ago
    • Promoted
    Transition of Care Coach (RN)

    Transition of Care Coach (RN)

    Molina Healthcare CareersATHENS, Georgia, US
    Full-time +1
    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: 14 days ago
    • Promoted
    Care Review Clinician (RN)

    Care Review Clinician (RN)

    Molina Healthcare CareersATHENS, Georgia, US
    Full-time +1
    Provides support for clinical member services review assessment processes.Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance p...Show moreLast updated: 14 days ago
    • Promoted
    Acute Dialysis Services Program Manager – RN

    Acute Dialysis Services Program Manager – RN

    Fresenius Medical CareNone, GA, US
    Full-time
    This position will manage 3 inpatient dialysis programs, at the following locations : 8954 Hospital Drive, Douglas, GA 30134 3950 Austell Rd, Austell, GA 30106 2518 Jimmy Lee Smith Pkwy, Hiram, GA 3...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    RN - Home Health

    RN - Home Health

    Enhabit Home Health & HospiceGREENSBORO, GA, US
    Full-time
    Are you in search of a new career opportunity that makes a meaningful impact? If so, now is the time to find your calling at Enhabit Home Health & Hospice. As a national leader in home-based care, E...Show moreLast updated: 17 hours ago
    • Promoted
    Surgical Services Manager

    Surgical Services Manager

    Morgan Medical CenterMadison, GA, US
    Full-time
    The Surgical Services Manager at Morgan Medical Center plays a pivotal role in overseeing the daily operations of the surgical department to ensure the delivery of high-quality patient care.This po...Show moreLast updated: 30+ days ago
    • Promoted
    Program Specialist II

    Program Specialist II

    University of GeorgiaAthens, GA, United States
    Full-time +1
    Pharmacy-Experiential Programs.About the University of Georgia.Since our founding in 1785, the University of Georgia has operated as Georgia's oldest, most comprehensive, and most diversified insti...Show moreLast updated: 7 days ago
    • Promoted
    Supervisor, Healthcare Services; Care Management (Remote - GA)

    Supervisor, Healthcare Services; Care Management (Remote - GA)

    Molina HealthcareAthens, GA, United States
    Remote
    Full-time
    This position will offer remote work flexibility, but the individual selected for the role must reside in Georgia.Leads and supervises multidisciplinary team of healthcare services professionals in...Show moreLast updated: 7 days ago