Talent.com
Program Manager, Healthcare Services - Clinical Systems
Program Manager, Healthcare Services - Clinical SystemsMolina Healthcare • Lexington-Fayette, KY, US
serp_jobs.error_messages.no_longer_accepting
Program Manager, Healthcare Services - Clinical Systems

Program Manager, Healthcare Services - Clinical Systems

Molina Healthcare • Lexington-Fayette, KY, US
job_description.job_card.variable_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.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.
  • serp_jobs.job_alerts.create_a_job

    Clinical Program Manager • Lexington-Fayette, KY, US

    Job_description.internal_linking.related_jobs
    Home Health RN Clinical Manager

    Home Health RN Clinical Manager

    Frankfort Regional Healthcare at Home • Lexington, KY, United States
    serp_jobs.job_card.full_time +1
    Do you have the career opportunities as a Clinical Manager RN you want with your current employer? We have an exciting opportunity for you to join Frankfort Regional Healthcare at Home which is par...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
    Program Manager (Vendor Management) -REMOTE

    Program Manager (Vendor Management) -REMOTE

    Molina Healthcare • Lexington, KY, US
    serp_jobs.filters.remote
    serp_jobs.job_card.full_time
    Provides support to Molina functional areas through program management, including policy, workflow and process documentation, management of program controls, vendor practices, budgets, governance f...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
    Travel Nurse RN - PCU - Progressive Care Unit

    Travel Nurse RN - PCU - Progressive Care Unit

    Nationwide Therapy Group • Danville, KY, US
    serp_jobs.job_card.full_time
    Nationwide Therapy Group is seeking a travel nurse RN PCU - Progressive Care Unit for a travel nursing job in Danville, Kentucky. Job Description & Requirements.Minimum Two (2) Years Bedside Cli...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Outpatient Physical Therapist

    Travel Outpatient Physical Therapist

    Critical Connection, inc • Georgetown, KY, US
    serp_jobs.job_card.full_time
    Critical Connection, inc is seeking a travel Outpatient Physical Therapist for a travel job in Georgetown, Kentucky.Job Description & Requirements. A Travel Physical Therapist or Local Travel Ph...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Senior Project Manager

    Senior Project Manager

    Medasource • Lexington, KY, US
    serp_jobs.job_card.temporary
    Large Healthcare Provider – Academic Medical Center.Our Healthcare client is looking for a resource to serve as a Senior Project Manager to commence the week of January 12th, 2026.This role is esti...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Physical Therapist

    Physical Therapist

    Cardinal Hill Rehabilitation Hospital • Georgetown, KY, US
    serp_jobs.job_card.full_time +1
    Physical Therapist Career Opportunity.Join a Team That Puts Your Passion for Care First.Are you seeking a fulfilling career that feels like home and lets you make a meaningful impact? At Encompass ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Nurse RN - Long Term Acute Care

    Travel Nurse RN - Long Term Acute Care

    Health Advocates Network - Nursing • Danville, KY, US
    serp_jobs.job_card.full_time
    Health Advocates Network - Nursing is seeking a travel nurse RN Long Term Acute Care for a travel nursing job in Danville, Kentucky. Job Description & Requirements.Health Advocates Network is ur...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Nurse RN - Long Term Acute Care

    Travel Nurse RN - Long Term Acute Care

    Solomon Page • Danville, KY, US
    serp_jobs.job_card.full_time
    Solomon Page is seeking a travel nurse RN Long Term Acute Care for a travel nursing job in Danville, Kentucky.Job Description & Requirements. Our client is looking to add a Registered Nurse to t...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Program Director, Endocrinology, Diabetes, and Metabolism Fellowship

    Program Director, Endocrinology, Diabetes, and Metabolism Fellowship

    Korn Ferry Executive Search • Lexington, KY, United States
    serp_jobs.job_card.full_time
    The University of Kentucky College of Medicine invites applications from qualified endocrinologists for the position of Program Director, Endocrinology, Diabetes, and Metabolism Fellowship.The Univ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    RN - Home Health

    RN - Home Health

    CenterWell Home Health - Danville, KY • Danville, KY, United States
    serp_jobs.job_card.full_time
    CenterWell Home Health - Danville, KY.Coast Medical Service is a nationwide travel nursing & allied healthcare staffing agency dedicated to providing an elite traveler experience for the experience...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Nurse Case Manager / UKHC

    Nurse Case Manager / UKHC

    University of Kentucky • Lexington, KY, United States
    serp_jobs.job_card.full_time
    Click here for more information about equivalencies : .Required License / Registration / Certification.This position requires intermittently sitting at a computer workstation for extended periods of time...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    RN - Home Health

    RN - Home Health

    CenterWell - 105 Citation Drive • Danville, KY, United States
    serp_jobs.job_card.full_time
    CenterWell - 105 Citation Drive.Pride Global and its entities offer eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insuran...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Associate Vice President, Growth & Community Engagement

    Associate Vice President, Growth & Community Engagement

    Confidential • Lexington, KY, US
    serp_jobs.job_card.full_time
    Associate Vice President, Growth & Community Engagement.Reputable managed care company for government-sponsored healthcare. The Company is seeking an Associate Vice President for Growth and Comm...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
    Nursing - Home Health

    Nursing - Home Health

    CenterWell Certified Healthcare Corp. - Danville, KY • Danville, KY, United States
    serp_jobs.job_card.full_time
    CenterWell Certified Healthcare Corp.Are you ready to take your Travel career to the next level? See places you have not seen before? Ventura's MedStaff tenured Recruiters are here to help you find...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Nursing Director

    Nursing Director

    USA Jobs • Lexington, KY, US
    serp_jobs.job_card.full_time +1
    NeuroRestorative, a part of the Sevita family, provides rehabilitation services for people of all ages with brain, spinal cord and medically complex injuries, illnesses and other challenges.In a va...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
    Travel Home Health Registered Nurse

    Travel Home Health Registered Nurse

    Ardor Health Solutions • Danville, KY, US
    serp_jobs.job_card.full_time
    Ardor Health Solutions is seeking a travel nurse RN Home Health for a travel nursing job in Danville, Kentucky.Job Description & Requirements. Ardor Health Solutions is looking for a Home Health...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    RN - Home Health

    RN - Home Health

    CenterWell Home Health (CWHH) Danville KY • Danville, KY, United States
    serp_jobs.job_card.permanent
    CenterWell Home Health (CWHH) Danville KY.Shift : 8 Hrs, 08 : 00 : 00-16 : 00 : 00, 8.When you join Synergy Medical Staffing, you'll have a dedicated recruiter helping you at all times.Your recruiter is a c...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    RN - Home Health

    RN - Home Health

    CenterWell Home Health - HH - DANVILLE - NEW • Danville, KY, United States
    serp_jobs.job_card.full_time
    CenterWell Home Health - HH - DANVILLE - NEW.Citation Dr B 6524 HH - DANVILLE - NEW.serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted