Clinical Project Manager

Job Summary

The Clinical Project Manager supports multi-functional clinical project management activities, including the implementation of new programmatic changes, initiatives, or vended solutions. This role also supports projects aligned with clinical and operational goals and objectives, contributing to the overarching strategy for providing quality and cost-effective member care at Molina Healthcare.

Essential Job Duties

• Develops, implements, and monitors clinical specialty project plans and program requirements and timelines, ensuring necessary support, tools, and technology are available and facilitating follow-up as needed.
• Meets with business process owners and other appropriate personnel to identify project goals, objectives, critical success factors, and success measures.
• Participates in the development of clinical management products and services, leading the enhancement of clinical programs and best practices.
• Assists with the development, enhancement, and maintenance of operational functions, policy, clinical support, and provider education.
• Oversees and coordinates the implementation of new specialty programs or processes, serving as a clinical liaison between Molina Healthcare and customers as needed to ensure appropriate implementation and monitoring of programmatic changes.
• Assists in modifying implementation approaches within budget and operational frameworks.
• Works jointly with leadership to ensure revenue goals and administrative expenses are managed.
• Develops and tracks appropriate metrics to monitor the quality and care cost impact of programs.
• Develops strong relationships with key internal and external contacts and teams to support achievement of increased revenue goals.
• Communicates across all departments and/or vendors and supports other functions throughout the program development lifecycle, including finance, outcomes, communications, and information technology.
• Maintains project plans for ongoing projects and programs to ensure deliverables are met.
• Responsible for the implementation of any required programs and process reporting.
• Escalates to leadership when projects or processes are at risk due to missed deliverables.

Required Qualifications

• At least 3 years of experience in clinical operations, preferably in a managed care setting supporting healthcare services, quality, network, pharmacy, and/or project management, or an equivalent combination of relevant education and experience.
• Strong project management skills.
• Understanding and knowledge of specialty programs integration and clinical initiative development and implementation.
• Data management and analytics expertise.
• Excellent problem-solving and organizational skills.
• Ability to work collaboratively across a highly matrixed organization.
• Strong interpersonal skills.
• Excellent verbal and written communication skills.
• Proficiency in Microsoft Office suite and applicable software programs.

Preferred Qualifications

• Registered Nurse (RN) or Licensed Practical Nurse (LPN) with an active and unrestricted license in the state of practice.
• Project Management Professional (PMP) or similar certification.
• Strategic planning and disease management experience.

Key skills/competency

• Clinical Project Management
• Managed Care
• Healthcare Operations
• Program Implementation
• Clinical Initiative Development
• Data Management
• Analytics
• Strategic Planning
• Stakeholder Engagement
• Process Improvement