Program Director, Healthcare Services

JOB DESCRIPTION Job Summary Provides senior level subject matter expertise and leadership to healthcare services function - providing support for project/program/process design, execution, evaluation and support, and ensuring compliance with regulatory and internal standards, practices, policies and contractual commitments. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties u2022 Manages one or more healthcare services clinical programs - leveraging staff and matrixed resources with oversight from health care services leadership as needed. u2022 Serves as industry subject matter expert in designated functional area(s), and leads program(s) to meet business needs and requirements. u2022 Escalates gaps and barriers in implementation and compliance to healthcare services leadership. u2022 Develops business case methodologies for programs and coordinates implementation of business strategies. u2022 Creates business requirement documents (BRDs), test plans, requirement traceability matrices (RTMs), user training materials and other related business documents and presentations. u2022 Provides ongoing communication related to program goals, evaluation and support to ensure compliance with standardized protocols and processes. u2022 May engage and oversee the work of external vendors. u2022 Focuses on process improvement, organizational change management, program management and other processes relative to business needs. u2022 Communicates and collaborates with customers to analyze and transform needs and goals into functional requirements. u2022 Conducts quality audits to assess healthcare services staff educational needs and service quality, and implements quality initiatives within the department as appropriate. u2022 Collaborates and facilitates activities with other business functions and within the enterprise. Required Qualifications u2022 At least 8 years of health care experience, including experience in managed care and/or clinical operations, or equivalent combination of relevant education and experience. u2022 Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC) or Licensed Marriage and Family Therapist (LMFT). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. u2022 Strong analytical and problem-solving skills. u2022 Strong organizational and time-management skills. u2022 Ability to work in a cross-functional, professional environment. u2022 Experience working within applicable state, federal, and third-party regulations. u2022 Strong verbal and written communication skills. u2022 Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications u2022 Registered Nurse (RN). License must be active and unrestricted in state of practice. u2022 Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM) Certified Professional in Healthcare Quality (CPHQ), or other health care or management certification. u2022 Operational and process improvement experience. u2022 Medicaid/Medicare population experience. u2022 Clinical experience. u2022 Leadership 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 #PJHS #LI-AC1 Pay Range: $88,453 - $172,484 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Created: 2026-02-09