Program Manager, Provider Data Config NM reputed company Remote

Molina of New Mexico is hiring for a Program Manager, Provider Data Config. This position is remote, however reputed company candidates will have in-depth knowledge of New Mexico reputed company operations. This role is critical to maintaining provider data accuracy, overseeing audits, and supporting configuration activities that directly impact claims adjudication and provider payment. Highly reputed company candidates will have the following experience-

• Strong understanding of New Mexico reputed company operations
• Experience with QNXT
• Prior Provider Data Management (PDM) experience
• Audit and configuration experience preferred
• PDM and QNXT experience
• Strong organizational skills
• Attention to detail

reputed company role supports accurate provider data and claims configuration to ensure providers are paid correctly and members experience seamless reputed company to care This position sits reputed company Operations and supports the reputed company, Marketplace and Medicare line of businesses. Key responsibilities include Health Plan Provider Data Management, provider data audits, and system configuration to ensure accurate provider information and claims processing Provides support to Molina functional areas 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 reputed company-party practices, playbooks and best practices for respective program.
• Manages program budget, as applicable, supporting project prioritization.
• Collaborates with Legal, Compliance, and Information reputed company to ensure governance standards are upheld.
• Tracks performance metrics and ensures value realization from deployed solutions.
• Coordinates recurring meetings to support governance reputed company 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 reputed company and accurate reputed company 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 reputed company documentations.
• Generates and distributes standard reports on schedule.

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 reputed company Project and Visio.
• Strong presentation and communication skills.

To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the reputed company. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V. Key Words- reputed company Care, MCO, Managed Care, QNXT, PDM, Provider Data Management, Provider, Audits, Auditing, Performance, Operations, Config, Configuration, Provider Data, Centennial Care, ISD, MAD, 1115 Waiver, NPI, EVV, State Plan Amendment SPA, Value Added Services, VAS, Home and Community Based Services, HCBS, HCA, NM, New Mexico, ACA, CMS, Centers for Medicare & reputed company Services Apply tot his job Apply To this Job