Marketplace Operations Manager

Job Description

Job Summary

The Marketplace Operations Manager plays a key role in the oversight and strategic development of the Marketplace network operations. Responsible for providing subject matter expertise for an array of Marketplace activities and overseeing key member experience and operational excellence initiatives. Enhances the efficiency and functionality of Marketplace Operations to ensure program success.

Job Duties

• Serves as a Subject Matter Expert (SME) for Marketplace operational activities, including Provider Gold Card, Process/Policy Management, PCP Auto Assignment, Appeals & Grievances, and Credentialing.
• Under the direction of Marketplace leadership, oversee and coordinate network operations processes
and infrastructure in collaboration with Health Plans and Health Plan Services
• Acts as liaison with Health Plan services and Health Plans; monitors performance metrics to ensure
optimal performance while identifying opportunities for process improvement and execution
• Anticipates and tracks operational and tactical risks; implements strategies and tactics in partnership with
Health Plan Services to mitigate any issues or performance not meeting established service levels;
enforces accountability and escalates to leadership as required
• Provides oversight of new projects and initiatives and drives relationship with vendors and external
partners to ensure project milestones are met
• Supports transparency to the Marketplace segment, ensuring appropriate awareness and operational
readiness for program and/or operational changes
• Supports health plans with product and message management; develops and oversees content for all
segment related materials, ensuring regulatory compliance and alignment with Molina brand
• Collaborates with cross-functional partners to ensure all operational, administrative, and compliance
functions within the Marketplace segment are properly executed in accordance with regulatory requirements
and segment best practices
• Develop business case and implementation plans for new programs, ensuring regulatory and business
milestones are met. Leads product implementations from start to finish, to include oversight of command
center and user acceptance testing; identifies and executes solutions to overcome any barriers
• Stays up to date on industry regulations, trends, and technology
• May work on other special planning and segment projects, as assigned

Job Qualifications

REQUIRED QUALIFICATIONS:

• Bachelor’s degree in program management, healthcare administration, business or public administration, technical management, or related fields
• 8+ years of experience with minimum of four (4) years of recent overall project/Ops management experience
• Ability to address operational concerns and issues, monitoring overall customer satisfaction
• Ability to develop and implement operational procedures and policies
• Excellent interpersonal communication and organizing skills to coordinate project activities
• Ability to communicate with others effectively
• Ability to conduct research for special projects, respond to timely inquiries, and presentations
• Ability to work with detail and time-sensitive issues
• Good decision-making skills and response to high-pressure situations

PREFERRED QUALIFICATIONS:

• Master of Business Administration (MBA)
• Experience in MS Project, Visio, Jira, etc. preferred.
• A Project Management Professional (PMP) certified by the Project Management Institute (PMI) can be used in lieu of the educational requirements

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing

Molina Healthcare offers a competitive benefits and compensation package Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $73,102 - $142,549 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.