医疗保健服务项目经理 - 临床分析/Pega/CCA - 远程
Program Manager, Healthcare Services - Clinical Analytics/Pega/CCA - Remote
***远程办公，必须居住在美国***
职位描述
职位概述
为跨健康计划的公司医疗保健服务策略的对齐和实施提供专业领域专业知识和领导力。作为公司团队与市场团队之间的联络人，促进沟通，识别运营风险和机会，支持变革管理努力，并促进项目实施的一致性。在确保了解监管、合同和组织优先事项的同时，为改善成员结果和运营绩效的企业举措的成功执行做出贡献。
主要工作职责
- 与公司和市场相关方合作，支持医疗保健服务举措的规划、实施和持续，确保与组织目标和市场需要一致。
- 作为公司团队和健康计划之间的关键沟通渠道，促进双向反馈、问题解决和信息共享。
- 通过识别实施障碍、运营风险和流程改进的机会，参与治理和监督活动，并与相关方合作制定和监控行动计划。
- 为健康计划提供关于企业项目、战略举措、监管要求和最佳实践的咨询和操作指导。
- 在临床、运营、合规、分析和其他业务合作伙伴之间促进跨职能协作，以推动举措的成功实施。
- 领导或支持组织变革管理努力，包括利益相关者参与、沟通计划和采用策略。
- 监控举措进展，评估结果，并向领导和关键利益相关者传达状态、风险、依赖关系和建议。
- 与公司团队和健康计划合作，收集业务需求，记录运营需求，并为新流程、工具、项目和报告功能的支持实施计划。
- 制定和维护项目文档、宣传材料、实施指南、执行摘要和其他资源，以支持利益相关者参与和运营执行。
- 通过培训协调、工作组主持和持续的运营支持，促进企业举措的市场准备和采用。
查看英文原文
***Remote and must live in the United States***
JOB DESCRIPTION
Job Summary
Provides subject matter expertise and leadership to support the alignment and implementation of enterprise healthcare services strategies across health plans. Serves as a liaison between enterprise and market teams, facilitating communication, identifying operational risks and opportunities, supporting change management efforts, and promoting consistency in program implementation. Ensures awareness of regulatory, contractual, and organizational priorities while contributing to the successful execution of enterprise initiatives that improve member outcomes and operational performance.
Essential Job Duties
- Collaborates with enterprise and market stakeholders to support the planning, implementation, and sustainment of healthcare services initiatives, ensuring alignment with organizational goals and market needs.
- Serves as a key communication conduit between enterprise teams and health plans, facilitating two-way feedback, issue resolution, and information sharing.
- Supports governance and oversight activities by identifying implementation barriers, operational risks, and opportunities for process improvement, while partnering with stakeholders to develop and monitor action plans.
- Provides consultation and operational guidance to health plans regarding enterprise programs, strategic initiatives, regulatory requirements, and best practices.
- Facilitate cross-functional collaboration among clinical, operational, compliance, analytics, and other business partners to drive successful implementation of initiatives.
- Leads or supports organizational change management efforts, including stakeholder engagement, communication planning, and adoption strategies.
- Monitors initiative progress, evaluates outcomes, and communicates status, risks, dependencies, and recommendations to leadership and key stakeholders.
- Partners with enterprise teams and health plans to gather business requirements, document operational needs, and support implementation planning for new processes, tools, programs, and reporting capabilities.
- Develops and maintains project documentation, communication materials, implementation guides, executive summaries and other resources to support stakeholder engagement and operational execution.
- Supports market readiness and adoption of enterprise initiatives through training coordination, facilitation of workgroups, and ongoing operational support.
- Analyzes market feedback, performance trends, and emerging issues to inform enterprise decision-making and continuous improvement efforts.
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, business operating model, 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.
- Project Management Professional (PMP), Lean Six Sigma, or other project management/process improvement certification preferred.
- Leadership experience.
- Medicaid/Medicare population experience.
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
Originally posted on Himalayas