Job Description

Job Description

Job Summary:

The Program Manager, Provider Network Data position reports directly to the Program Director in the Network Department. This role requires a self motivated and fast paced person with working knowledge of data, the ability to understand business requirements, and lead efforts to ensure provider data integrity, fulfill regulatory reporting requirements and enhance data flow processes. The PM collaborate with various departments including Government Contracts, Operations, IT, Claims, and Quality Improvement on projects related to data such as claims resolutions, block transfers activities for termed providers, regulatory report completions, provider directory, etc.

Knowledge, Skills & Abilities:

* Responsible for understanding and implementing regulatory reporting data spec changes to accurately reflect reports.
* Actively participate in Provider Network related projects and committees to provide guidance and assistance around provider data reporting needs.
* Manage ad lead data projects with other departments around provider activities, data clean up, provider directory, etc.
* Foster positive working relationships with all departments and engage in workgroups to improve provider data accuracy, identify root cause and resolve issues.
* Manage and QA provider data to identify issues, report on provider data integrity, accuracy, and trends and provide recommendations.
* Support Network department in reporting requirements and setting up tracking processes.
* Where department resources are not available, work with IT, Ops and other departments to coordinate efforts, identify opportunities for automation and ensure timely project completion.
* Be able to provide succinct analyses of reports, data, processes, create graphs and presentations
* Process improvement minded
* Be able to work in a deadline driven environment.
* Document processes and write SOPs and desktop procedures.

Job Qualifications

Required Education:
Bachelor's Degree or equivalent combination of education and experience.

Required Experience:
3-5 years of Program and/or Project management experience.
Operational Process Improvement experience.
Healthcare experience.
2+ years working with large complex data and reports.
Proficiency in Excel.
Ability to read SQL queries.
Excellent presentation and communication skills.
Experience partnering with different levels of leadership across the organization.

Preferred Education:
Graduate Degree, Business Administration, Data Administration or equivalent combination of education and experience.

Preferred Experience:
5-7 years of Program and/or Project management experience.
Managed Care experience.
Provider/Network experience.
Ability to read and write complex SQL queries.
QNXT experience.
Experience working with state, federal and third party regulations.
Experience working in a cross functional highly matrixed organization.

Preferred License, Certification, Association:
PMP, Six Sigma Green Belt, Six Sigma Black Belt Certification and/or comparable coursework desired.

PHYSICAL DEMANDS:

Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Type: Full Time Posting Date: 03/16/2021