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Vice President of Member Services
2 months ago
Key Responsibilities
• Oversee all aspects of Member and Provider Services, including Workforce Management, Reporting, Data & Analytics, Quality Assurance, Business Solutions, Vendor Performance, and Telephony across Medicaid, Medicare, and Marketplace.
• Formulate and implement strategic initiatives aimed at achieving operational excellence to enhance growth and improve satisfaction for both members and providers.
• Cultivate and sustain robust relationships with internal and external stakeholders to ensure optimal shared services across the organization.
• Manage the seamless integration of newly acquired personnel, including defining scope of work and organizational structure.
• Identify and lead projects that minimize administrative expenses while introducing innovative solutions. Assemble workgroups, develop implementation strategies with clear tasks, timelines, and responsibilities. Execute and evaluate outcomes.
• Supervise Molina staff directly and oversee vendor performance to ensure accountability for services delivered to the contact center, aiming for operational efficiency at minimal cost while maintaining high service quality across all business lines.
• Ensure compliance with all state, federal, and Molina regulations, policies, and procedures consistently to uphold the highest standards of compliance within Corporate Operations.
• Set and manage overall budgets to meet or exceed annual financial targets for all operational areas, while continuously seeking opportunities to enhance productivity and automation to lower costs.
• Design and implement systematic approaches to enhance member and provider experiences through improved operational efficiency and effectiveness.
• Responsible for reporting potential financial liabilities and tracking accruals to senior leadership.
• Demonstrate the ability to influence and drive organizational change among peers and other stakeholders.
• Skillfully envision, develop proposals, and gain consensus for the approval and implementation of future processes and systems that align with the strategic direction of the organization.
• Maintain confidentiality and adhere to the Health Insurance Portability and Accountability Act (HIPAA).
• Establish and nurture positive and effective working relationships with colleagues, clients, members, providers, and customers.
• Perform additional duties as assigned.
Qualifications
Education
Bachelor's Degree required.
Experience and Skills
• Minimum of 10 years in healthcare contact center and operational roles.
• At least 10 years of leadership experience managing large teams.
• Proven experience in overseeing operations across multiple markets and product lines, with expertise in data analytics, customer experience, workforce management, and quality metrics.
• Experience in developing and managing departmental budgets within set parameters.
• Familiarity with account management responsibilities at the senior leadership level.
• Proficient in using Genesys and Salesforce platforms.
Preferred Qualifications
• Master's Degree or relevant healthcare experience preferred.
• Experience in implementing process improvements within a matrix environment.
• Knowledge of Medicaid and Medicare systems.
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Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $186,201 - $363,093 / ANNUAL
*Actual compensation may vary based on geographic location, work experience, education, and/or skill level.
