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Molina Healthcare Inc.

Project Manager (Appeals & Grievances)

Posted Yesterday
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Remote
Hiring Remotely in United States
Mid level
Remote
Hiring Remotely in United States
Mid level
Manages multiple Appeals and Grievances projects from inception through delivery, overseeing scope, schedules, resources, budgets, quality, stakeholders, and change management. Develops project plans, status reports, process documentation, SOPs, workflows, and PEGA job aids. Coordinates process improvements, governance changes, vendors, training, and cross-functional collaboration with executive, operational, and PEGA teams across multiple regions.
The summary above was generated by AI

JOB DESCRIPTION Job Summary

Provides support for internal business projects from inception through delivery.  Plans and managed project schedules, milestones, budgets, stakeholder involvement, and quality/delivery.  Collaborates cross-functionally with departments and cross-functional teams of subject matter experts to ensure project completion and success.

This candidate will be supporting multiple Appeals and Grievances regions


Essential Job Duties

  • Manages all aspects of assigned projects throughout the project lifecycle including project scope, schedule, resources, quality, costs and change; supports projects of moderate to high-level complexity.  
  • Develops and maintains detailed project plans to include milestones, tasks, and target/actual dates of completion.
  • Revises project plans as appropriate to meet changing needs and requirements.
  • Schedules and conducts project meetings to include logistics, agendas, and meeting minutes.
  •  Prepares and submits project status reports to leadership.
  •  Facilitates project follow-up items with applicable stakeholders.
  • Coordinates project-related process improvements, workflow changes, project/program implementation and governance changes, etc.
  • May engage and oversee the work of external vendors.
  • Provides training and support to new and existing project management team members.
  • Act as a liaison between Appeals & Grievances and PEGA teams.
  • Manage SOPs, Workflows, job aide for Pega
  • Create process documents across all states
  • Work with executive teams. 

 

Required Qualifications

  • At least 3 years of professional experience in project management or a related role, or equivalent combination of relevant education and experience.
  • Operational/process improvement experience.
  • Project management experience/skills.
  •  Knowledge of project management methodologies (Waterfall, Agile, or hybrid).
  •  Data analysis skills/experience.
  • Strong problem-solving skills.
  • Strong organizational and time-management skills.
  • Proven ability to manage multiple projects simultaneously with competing priorities.
  •  Ability to create clear, accurate, complete, and concise reports.
  • Ability to effectively lead small meeting and capture concise notes and action items.
  •  Ability to work cross-collaboratively across a highly matrixed organization.
  • Effective verbal/written/presentation communication skills.
  • Microsoft Office suite (including Excel, PowerPoint, Project, and Visio), and applicable software programs proficiency.
     

Preferred Qualifications

  • Project Management Professional (PMP) and/or Six Sigma Green Belt certification.
  • Health care/managed care 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

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