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