Program Manager - REMOTE

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Molina Healthcare. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Job DescriptionJob Summary Provides program management and strategic oversight for provider engagement, quality improvement, and risk adjustment initiatives. The position is responsible for planning, coordinating, and monitoring cross-functional programs that support regulatory compliance, quality performance, and accurate risk adjustment outcomes. Working closely with internal stakeholders and external partners. The role analyzes performance data, tracks initiatives, manages deliverables, and drives continuous improvement to support value-based care and improved member outcomes. Job Duties

• Responsible for driving provider performance and partnership across provider engagement, quality improvement, and risk adjustment initiatives
• Responsible for ensuring well-documented policies, workflows, program controls, internal and third-party practices, playbooks and best practices for respective program.
• Performs analysis of performance data and implement improvement strategies that support Value-Based Care, Quality, Risk Adjustment, Provider Engagement, and positive member health outcomes.
• Manages program budget, as applicable, supporting project prioritization.
• Collaborates with Legal, Compliance, and Information Security to ensure governance standards are upheld.
• Tracks performance metrics and ensures value realization from deployed solutions.
• Coordinates recurring meetings to support governance framework and decision-making processes, as needed.
• At the direction of program (CoE, Shared Service or other functional area) leadership, supports portfolio management and/or initiative-specific change and project management.
• Collaborates with key stakeholders to support dissemination and adoption of program guardrails, processes, best practices and other collateral.
• Routinely reviews program collateral to ensure current and accurate reflection of business needs.
• Identifies opportunities/gaps and provides recommendations on program enhancements to respective leadership team.
• Responsible for creating business requirements documents, test plans, requirements traceability matrix, user training materials and other related documentations.
• Generates and distributes standard reports on schedule.

Job QualificationsREQUIRED QUALIFICATIONS :

• At least 4 years of Program and/or Project management experience, or equivalent combination of relevant education and experience.
• Operational Process Improvement experience.
• Managed Care experience, preferably in a shared service, CoE or matrixed environment.
• Experience with Microsoft Project and Visio.
• Strong presentation and communication skills.

Preferred Experience

• Understanding of healthcare provider engagement or payer–provider program management.
• Experience working in managed care, health plans, or healthcare networks (Medicaid, Medicare, Marketplace).
• Knowledge of state and federal healthcare regulations, including CMS and Medicaid requirements.
• Familiarity with clinical, quality, or risk adjustment program workflows.
• Understanding of HEDIS, CAHPS, STAR Ratings, and quality benchmarking methodologies.
• Ability to interpret healthcare data and translate insights into program improvements.
• Experience tracking KPIs, closure rates, and program performance metrics.
• Detail-oriented with strong follow-through and accountability.

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. #PJCorp Pay Range: $80,168 - $129,590 / ANNUAL

• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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