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Vice President of Member Services

2 months ago

Covington, Kentucky, United States Molina Healthcare Full time

Position Overview

The Vice President of Member Services is accountable for overseeing all aspects of Member and Provider Services, which encompasses Workforce Management, Reporting, Data & Analytics, Quality Assurance, Business Solutions, Vendor Performance, and Telephony across Medicaid, Medicare, and Marketplace.
This role involves formulating and executing strategic initiatives aimed at achieving operational excellence to bolster growth and enhance satisfaction for both members and providers.
Building and nurturing robust relationships with internal and external stakeholders is crucial to ensure optimal shared services across the organization.
The position also entails managing the seamless integration of newly acquired personnel, including defining the scope of work and organizational structure.
Identifying projects and initiatives that minimize administrative expenses while introducing innovative solutions is a key responsibility. This includes convening work groups, crafting implementation plans with designated tasks, timelines, and responsible parties, and measuring success.
The VP will supervise Molina staff directly and oversee vendor performance, ensuring accountability for services rendered to the contact center. This oversight is essential for achieving operational results at the lowest possible cost while maintaining consistent and compliant service levels and the highest quality across all business lines.
Ensuring adherence to all state, federal, and Molina regulations, policies, and standard operating procedures is vital for maintaining the highest level of compliance within Corporate Operations.
The role requires setting and managing overall costs to meet or exceed annual budgets for all areas, while continuously seeking opportunities to enhance productivity and automation to reduce unit costs and overall general and administrative expenses.
A systematic approach to improving member and provider experiences through increased operational efficiency and effectiveness is expected.
The VP will also be responsible for reporting potential financial liabilities and accruals to senior leadership.
The ability to influence and drive change among peers and within the Molina organization is essential.
Skills to envision, develop proposals, gain consensus, and implement future state processes and systems aligned with the organization's strategic direction are necessary.
Maintaining confidentiality and compliance with the Health Insurance Portability and Accountability Act (HIPAA) is imperative.
Establishing and sustaining positive and effective working relationships with coworkers, clients, members, providers, and customers is crucial.
Additional responsibilities may be assigned as needed.

Qualifications

Education
Bachelor's Degree required.
Experience and Skills
10 years of experience in healthcare contact center operations.
10 years of leadership experience managing large teams.
10 years of experience overseeing operations across multiple markets and product lines, along with expertise in data analytics, customer experience, workforce management, and quality metrics.
Proven experience in developing and managing departmental budgets within set parameters.
Experience in account management with senior leadership.
Familiarity with Genesys and Salesforce is preferred.
Preferred Education
Master's Degree or relevant healthcare experience.
Preferred Experience
Experience in implementing process improvements within a matrix environment.
Experience with Medicaid and Medicare is advantageous.

Compensation
Pay Range: $186,201 - $363,093 / ANNUAL
*Actual compensation may vary based on geographic location, work experience, education, and/or skill level.

Industries
Other