Manage claims program governance, policies, workflows, controls, budgets and vendor practices. Drive portfolio/initiative change, create requirement/test/training documentation, track metrics, coordinate governance meetings, and recommend program enhancements to improve adoption and value realization.
JOB DESCRIPTION
Job Summary
Provides support to Molina functional areas (Claims, and claims configuration) through program management, including policy, workflow and process documentation, management of program controls, vendor practices, budgets, governance frameworks, playbooks and best practices, and champion networks, as applicable.
Job Duties
- Responsible for ensuring well-documented policies, workflows, program controls, internal and third-party practices, playbooks and best practices for respective claims & claims configuration program.
- 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 QUALIFICATIONS
REQUIRED 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 QUALIFICATIONS:
- Clams & claims configuration experience.
- QNXT
- Provider Relations
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.
Similar Jobs
Automotive • Big Data • Information Technology • Robotics • Software • Transportation • Manufacturing
Perform vehicle-level CFD for water management and splash performance, assess water ingestion risk for exterior and underbody systems, use FEA/CAE for exterior component evaluation, recommend design solutions, create/update CAE geometry, lead suppliers/internal teams, present results, and develop simulation methods and process improvements.
Top Skills:
CaeCfdFeaLs-DynaMS OfficeNastranOptistructPowerflowPreonlabStar-Ccm+Ug-Nx (Nx)
Automotive • Big Data • Information Technology • Robotics • Software • Transportation • Manufacturing
Territory-focused commercial fleet district manager consulting with dealers to grow Business Elite/Medium Duty programs. Responsibilities include dealer coaching, sales and market analysis, B2B marketing, telematics and OnStar sales, training, policy administration, and frequent in-person dealership visits (6–8 meetings/week) with heavy travel.
Top Skills:
ExcelMicrosoft WordOnstarOutlookOvi TelematicsPowerPoint
Automotive • Big Data • Information Technology • Robotics • Software • Transportation • Manufacturing
Field leadership role advising dealership owners and senior leaders to improve parts and service performance. Responsibilities include relationship management, data-driven analysis, developing and executing business plans, driving KPIs (NPS, retention, SRT), resolving aftersales issues, and frequent regional travel to support dealer operations and training.
Top Skills:
ExcelPowerPointSales Reporting Tool (Srt)
What you need to know about the Chicago Tech Scene
With vibrant neighborhoods, great food and more affordable housing than either coast, Chicago might be the most liveable major tech hub. It is the birthplace of modern commodities and futures trading, a national hub for logistics and commerce, and home to the American Medical Association and the American Bar Association. This diverse blend of industry influences has helped Chicago emerge as a major player in verticals like fintech, biotechnology, legal tech, e-commerce and logistics technology. It’s also a major hiring center for tech companies on both coasts.
Key Facts About Chicago Tech
- Number of Tech Workers: 245,800; 5.2% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: McDonald’s, John Deere, Boeing, Morningstar
- Key Industries: Artificial intelligence, biotechnology, fintech, software, logistics technology
- Funding Landscape: $2.5 billion in venture capital funding in 2024 (Pitchbook)
- Notable Investors: Pritzker Group Venture Capital, Arch Venture Partners, MATH Venture Partners, Jump Capital, Hyde Park Venture Partners
- Research Centers and Universities: Northwestern University, University of Chicago, University of Illinois Urbana-Champaign, Illinois Institute of Technology, Argonne National Laboratory, Fermi National Accelerator Laboratory

