Molina Healthcare
Administers government-sponsored Medicaid, Medicare plans
Program Manager - Claims
More locations: Las Cruces, NM, USA | Albuquerque, NM, USA | Santa Fe, NM, USA | Roswell, NM, USA
On-site role in New Mexico; no remote option.
About the job
- 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.
- Responsible for ensuring well-documented policies, workflows, program controls, internal and third-party practices, playbooks and best practices for respective claims and 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.
- Clams & claims configuration experience.
- QNXT
- Provider Relations
About the company
Molina Healthcare provides government-sponsored health plans in the United States, primarily serving low-income individuals and families through Medicaid, Medicare, and Marketplace products. It partners with state and federal governments to administer these programs and earns revenue from member premiums and payments for program management. A key differentiator is its focus on cost management and preventive care, aided by an online provider portal that lets clinicians verify eligibility, submit claims, and access resources. Its goal is to expand access to affordable, quality health coverage while delivering sustainable administration of government-backed plans.
Company Size
10,001+
Company Stage
IPO
Headquarters
Long Beach, California
Founded
1980
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Simplify's Take
What believers are saying
- July 22, 2026 guidance rose to at least $5.25 EPS after Medicaid strength.
- Management called 2026 Medicaid margins a trough, signaling improving 2027 profitability.
- August 2026 cash-heavy balance sheet supports contract transitions and state-by-state expansion.
What critics are saying
- Marketplace deteriorated in Q2 2026; management cut 2026 outlook to a $0.75 loss.
- The company will exit traditional MAPD in 2027 and absorb Florida contract losses.
- Securities class actions and shareholder investigations persist since February 2025, pressuring management credibility.
What makes Molina Healthcare unique
- Molina dominates government-sponsored plans, especially Medicaid, across 21 states.
- Its local-state operating model fits low-income populations and complex managed-care contracts.
- MolinaCares deepens community partnerships, reinforcing provider and school relationships.
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Benefits
Health Insurance
401(k) Retirement Plan
Remote Work Options
Paid Vacation
Flexible Work Hours
Wellness Program
Mental Health Support
Conference Attendance Budget
Professional Development Budget
Phone/Internet Stipend
Home Office Stipend
Family Planning Benefits
Fertility Treatment Support
Stock Options
Company Equity
Hybrid Work Options
PTO/vacation mention not explicit beyond Paid Vacation
Paid Sick Leave
Paid Holidays
Adoption Assistance
Company News
Press release: The Molina Healthcare Charitable Foundation awards $15,000 grant to Ozark Center for Behavioral Health training in southwest Missouri schools. On: September 23, 2026 The Molina Healthcare Charitable Foundation ("MolinaCares"), in collaboration with Molina Healthcare of Missouri ("Molina"), awarded a $15,000 grant to the Ozark Center, an entity of Freeman Health System, to launch the Rural Behavioral Health Rapid Access and Transition Coordination Pilot. The grant will fund training for school staff, educational resources for families, and stronger referral pathways in rural school districts in the Joplin area. "Access to behavioral healthcare is limited in rural communities, and schools are often on the front lines of identifying students in need," said Vicky Mieseler, chief executive officer at Ozark Center. "With Molina's funding, we will train school staff in the Joplin area to recognize and respond to behavioral health challenges, provide families with practical information and referral resources, and connect students to support before concerns escalate to a crisis." Grant funds will pay for behavioral health awareness and early identification training for teachers, counselors, administrators, and school nurses. It will also support printed and digital education materials, referral guides, and prevention resources for students and families as well as parent engagement and community awareness events. Ozark Center expects to train 50 to 100 school personnel directly and reach up to 2,000 students and their families indirectly. "Access to behavioral health resources is key to helping young people build resiliency, overcome challenges and stay in school," said Jay Ludlam, plan president of Molina Healthcare of Missouri. "By partnering with the Ozark Center, Molina is helping create a sustainable model that can strengthen school-based supports for Missouri youth in rural areas." Findings from the pilot, including training results and family engagement data, will be used to determine whether the model can be extended to additional districts.
Molina Healthcare of Michigan awards $20,000 in scholarships to UM-Flint and Mott Community College students to address shortages in healthcare fields. by Tanya September 18, 2026 158 FLINT, Mich., Sept. 17, 2026 - Molina Healthcare of Michigan ("Molina"), in partnership with University of Michigan-Flint ("UM-Flint") and Mott Community College, announced recipients of four scholarships awarded to students in the dental and social work programs in their respective schools. These particular healthcare fields are experiencing shortages throughout Michigan, particularly in traditionally underserved communities. The recipients are: * Brooklyn Daly, dental hygiene student, Mott Community College * Tasheikya Hunter, Master of Social Work student, UM-Flint * Mandi Villarreal, Master of Social Work student, UM-Flint * Stephanie Wooster, dental hygiene student, Mott Community College The winners were chosen, in part, based on their intention to remain in the state and practice in low-income areas where services are lacking. According to a report released in March by the Michigan State Medical Society, almost one-third of Michiganders lack access to primary care which can cause delays in treatment, poorer health outcomes and widening disparities. "This scholarship represents a transformative opportunity for Mott Community College's Dental Hygiene students," shared Shaunda Richardson-Snell, president of Mott Community College. "By supporting key program expenses, including specialized equipment and national board preparation, this generous gift helps clear the runway for our students to excel academically and step seamlessly into rewarding careers. We are incredibly grateful for the extraordinary support." "Molina's generous support reflects a shared commitment to building healthier, more resilient communities," said Shan Parker, dean of the University of Michigan-Flint College of Health Sciences. "By reducing financial barriers for our Master of Social Work students, these scholarships will help prepare the next generation of skilled, compassionate social workers to serve individuals and families throughout Flint and the region." "There is a correlation between community health and access to care, and these scholarships are investment in the future well-being of Michiganders by increasing the pool of practitioners," said Terrisca Des Jardin, plan president for Molina Healthcare of Michigan. "We congratulate the winners and look forward to the impact they will make in the lives of those they serve in the years to come." About Molina Healthcare of Michigan Molina Healthcare of Michigan, Inc. provides government-funded, quality health care, serving members through Medicaid, Medicare and Marketplace programs in Michigan. Through its locally operated health plans, Molina Healthcare, Inc., a Fortune 500 company, provides managed health care services under the Medicaid and Medicare programs, and through state insurance marketplaces. For more information about Molina Healthcare of Michigan, visit MolinaHealthcare.com.
Dentsply Sirona and Novavax face significant operational challenges, while Molina Healthcare shows more promise, according to a recent stock analysis. Healthcare stocks have returned 25.1% over the past six months, outperforming the S&P 500 by 13.1 percentage points. Dentsply Sirona, which manufactures dental equipment, has seen earnings per share drop 13.6% annually over five years. Its negative returns on capital suggest management is losing money whilst attempting to expand the business. Novavax, a vaccine developer, has experienced revenue declining 18.9% annually over the last five years. The company's adjusted operating margin fell 26.9 percentage points over two years as it struggled to adjust its cost structure. Both companies face regulatory pressures typical of the healthcare sector, which can significantly influence their earnings potential.
Corient Private Wealth LP acquired a new stake in Molina Healthcare, Inc (NYSE:MOH – Free Report) in the 2nd quarter, according to the company in its most recent Form 13F filing with the Securities and Exchange Commission. The fund acquired 11,823 shares of the company’s stock, valued at approximately $2,704,000. A number of other hedge […]
Press release: The Molina Healthcare Charitable Foundation grants $25,000 to the Missouri Rural Health Association to support Rural Health leadership and mentorship program. On: August 27, 2026 The Molina Healthcare Charitable Foundation ("MolinaCares"), in collaboration with Molina Healthcare of Missouri ("Molina"), has awarded a $25,000 grant to the Missouri Rural Health Association ("MRHA") to launch the Causeway Lighthouse, a mentorship initiative connecting rural health leaders across the state. The program extends MRHA's "Causeway," a free, virtual community offering resources, case consultations, and legislative tracking. Missouri's rural communities face significant healthcare workforce challenges, with over 78% of the state's Health Professional Shortage Areas in rural areas. A 2024 MRHA assessment of healthcare professionals found widespread professional isolation, limited access to reliable resources, and gaps in communication training, along with strong interest in a shared peer network. The Causeway Lighthouse responds directly to these findings, pairing rural health leaders through structured mentorship and peer support. "Rural health leaders do their best work when they have peers to learn from and a structure to support their growth," said Heidi Lucas, executive director, Missouri Rural Health Association. "Molina's grant allows the rural health workforce a place inside the Causeway where established leaders mentor emerging ones through direct listening, hands-on onboarding, and ongoing peer support." The Causeway Lighthouse will operate as a centralized, virtual hub where rural health leaders connect for peer-to-peer mentorship and collaborative problem-solving. The MolinaCares grant funds recruitment and onboarding of emerging and established rural health leaders, one-on-one listening sessions, and mentor preparation. "Consistent mentorship and peer support strengthens the healthcare workforce, thereby improving the continuum of care," said Jay Ludlam, plan president, Molina Healthcare of Missouri. "By supporting MRHA's Causeway Lighthouse, we are creating a practical forum for leaders where the sharing of knowledge and shared challenges results in healthier outcomes for Missouri's rural communities." Interviews are underway to identify mentors for the Causeway Lighthouse community. The initiative is expected to launch in December 2026. The grant is part of Molina's Advancing Health: Powered by Local Partnerships initiative, which invests in community-based organizations that remove barriers to care and improve health outcomes.