VP, Market LeaderBoise, Idaho Job ID 1901894
Molina Health Plan Operations jobs are responsible for the development and administration of our State health plan's operational departments, programs and services, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations.
Responsible for the overall direction and administration of the operations, programs and services for a market or product within the health plan. Serves as lead executive responsible for working with the Health Plan, State and Molina Corporate to ensure a competitive focus on membership retention, loyalty and satisfaction relative to the specific product or market. Provides oversight for various Local/Product-specific functions/departments in multiple office locations (e.g., Local/Product-specific Network Contracting, Community Engagement, etc.).
• Formulates and implements Local/Product-specific business plans, tactics and strategies to provide efficient, effective and compliant operations to meet short-term objectives and ensure long-term growth and success for the local market or product.
• Identifies and drives Local/Product-specific initiatives to optimize performance and functionality.
• Increases member and provider satisfaction through internal complaint or operational management, Joint Operations Committees, constituent calls from legislators, regulatory requests, etc.
• Ensures appropriate cost per unit contracts with key providers via contract development or renegotiation.
• Ensures appropriate access to health care services through local- or product-specific network development.
• Identifies and implements cost savings initiatives in contracting, operations and employee productivity.
• Achieves growth targets for the local market or product via local community engagement deployment.
• Serves as a local resource for legislators, regulators, advocates, providers and members. Engages as an active participant in applicable external leadership boards and committees.
• Facilitates interaction between internal Healthcare Services and Provider Network Contracting/ Services departments to ensure timely, appropriate access to care for members and satisfaction for providers.
• Serves as the office lead and local executive to address general issues for all Molina staff in their assigned locale regardless of departmental reporting relationship.
• Ensures the overall level of quality for operational and contractual obligations meet or exceed appropriate standards.
• Provides personal leadership that encourages employee productivity and responsiveness to the needs of current and prospective members, providers and regulatory agencies/staff.
• Ensures programs are established to comply with all relevant federal, state and local regulations.
Bachelor's Degree in Business, Health Services Administration or related field.
• 15+ years progressive experience in the managed healthcare industry, including 10 years of managed care management experience.
• Strong knowledge of Molina operations, policies and procedures.
Required License, Certification, Association
Master's Degree in Business, Public Administration, Health Services Administration or related field.
• Transition and/or acquisition experience.
• Direct experience with Medicaid and Medicare managed care plans.
Preferred License, Certification, Association
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.