Healthcare Operations Director

1 week ago


Miami, United States Molina Healthcare Full time
About Molina Healthcare

Molina Healthcare is a leading healthcare provider dedicated to delivering quality care and innovative solutions to our patients.

Job Summary

We are seeking an experienced AVP, Health Plan Operations to join our team. The ideal candidate will have 7-10 years of experience in healthcare administration, health plan operations, managed care, and/or provider services. This role will direct and coordinate health plan operations, ensuring compliance with all relevant federal, state, and local regulatory requirements.

Responsibilities
  • Directs analytical activities to identify trends and potential opportunities that may impact the functionality of health plan operations
  • Manages benefit configuration, claim payment policies, and maintenance/modification to support accurate and timely claims payment
  • Ensures compliance with regulatory requirements and accurate claims and encounter submissions
  • Liaises with enrollment and contact center operation leaders to ensure full and consistent compliance with health plan state contract and regulatory requirements
  • Partners to support plan encounter submissions to regulators
Requirements
  • Bachelor's degree in business, health services administration, or related field
  • 7-10 years' experience in healthcare administration, health plan operations, managed care, and/or provider services
  • Experience managing/supervising employees
  • Demonstrated adaptability and flexibility to a rapidly moving business environment
Benefits

We offer a competitive salary range of $120,000 - $180,000 per year, depending on experience. Additionally, we provide a comprehensive benefits package, including medical, dental, and vision coverage, 401(k) matching, and paid time off.


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