Molina Healthcare

Compensation

Full Description

Note: The job is a remote job and is open to candidates in USA. Molina Healthcare is seeking a Senior Managed Care Operations (MCO) Project Manager to oversee internal business projects and programs. The role involves planning, executing, and delivering projects on time and within budget while managing resources and ensuring stakeholder satisfaction. Responsibilities • Manages people who are responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts. • The ideal candidate will be responsible for planning, executing, and delivering projects on time, within scope, and within budget. • This role requires strong leadership, communication, and problem-solving skills to manage resources, mitigate risks, and ensure stakeholder satisfaction. • Builds work breakdown structures, monitors task activities, and ensures state contract timelines are met. • Monitors the project from inception through delivery. • May engage and oversee the work of external vendors. • Assigns, directs and monitors project teams through requirement solicitation, requirement documentation, and Sponsor approvals. • Works as the liaison between the health plan and IT to ensure requirements are interpreted correctly and the development lifecycle timeline is being followed. • Communicates project status through weekly reporting, project status meetings, and leadership presentations. • Manages the project RACI and RAID log, project plan, and other project management tools. • Defines project scope, goals, and deliverables in collaboration with stakeholders. • Develops detailed project plans, schedules, and resource allocations. • Leads project teams, assigns tasks, and monitors progress. • Manages budgets, timelines, and project risks. • Communicates project status, issues, and milestones to stakeholders and leadership. • Ensures quality standards and compliance with company policies. • Facilitates meetings, workshops, and presentations. • Identifies and resolves project roadblocks and conflicts. • Strong analytical, organizational, and decision-making skills. • Experience working with IT waterfall and agile system development lifecycle methodologies. • Experienced in working with claims and claim configuration teams to streamline adjudication and resolve claim processing issues. • Familiar with payment integrity and other cost recovery processes. • Direct PM experience in Managed Care Operations (claims, system configuration, provider data management preferred). • Demonstrated ability to solicit and formally document business and functional requirements. • Accustomed to working with IT to ensure Health Plan requirements and timelines are met. • Understands Medicaid and Medicare business scenarios and appreciates the member environments we serve. • Exposure to all Managed Care industry functional departments. Skills • 5-7 years experience as a Health Insurance industry Project Management professional • Graduate Degree or equivalent combination of education and experience • 7-9 years as Health Insurance industry Project Management professional • 3-5 years in Managed Care with emphasis on Managed Care Operations • PMP, CAPM, PMI-ACP, PMI-PBA or Six Sigma Black/Green Belt certification Education Requirements • Bachelor's Degree or equivalent combination of education and experience Benefits • Competitive benefits and compensation package Company Overview • Molina Healthcare is a healthcare company that specializes in government-sponsored healthcare programs for families and individuals. It was founded in 1980, and is headquartered in Long Beach, California, USA, with a workforce of 10001+ employees. Its website is https://www.molinahealthcare.com. Company H1B Sponsorship • Molina Healthcare has a track record of offering H1B sponsorships, with 47 in 2025, 45 in 2024, 43 in 2023, 31 in 2022, 35 in 2021, 55 in 2020. Please note that this does not guarantee sponsorship for this specific role.