VP Member & Provider Contact Center Operations

Molina Healthcare
US - Kentucky - Covington
July 1, 2024

Job Duties

• Responsible for all Member and Provider Services, including Workforce Management, Reporting, Data & Analytics, Quality Assurance, Business Solutions, Vendor Performance and Telephony across Medicaid, Medicare and Marketplace.

• Develops and drives strategic initiatives, including operational excellence, in order to support growth as well as increase member and provider satisfaction.

• Develops and maintains strong relationships with internal and external stakeholders to provide optimal shared services throughout the enterprise.

• Responsible for seamless integration of newly acquired employees, including scope of work and structure.

• Identifies projects/initiatives that reduce administrative costs and introduce innovative solutions. Convenes work groups, develops implementation plans with identified tasks, timelines and assigned parties. Executes and measures success.

• Manages direct Molina staff as well as oversees vendors and performance accountability for services rendered to contact center, which will enable the organization to produce operational results at the lowest possible cost, the most consistent and compliant service levels and the highest level of quality for all lines of business.

• Ensures all state, federal and Molina regulations, Policies/Procedures and SOPs are implemented and followed on a consistent basis to ensure the highest compliance possible within the Corporate Operations areas.

• Sets and manages overall costs to meet/exceed annual budgets set for each or all of the areas and finds ways to improve productivity and automation wherever possible to reduce unit costs and overall G&A for the organization.

• Designs and implements systematic approach to improve member and provider experiences through increased operational efficiency and effectiveness.

• Responsible for reporting potential liabilities for financial tracking and accruals to senior leadership.

• Ability to influence and drive change among peers and others within the Molina organization

• Skill to envision, craft proposals, obtain consensus around approving and implementing future state processes and systems needed to support strategic direction set by organization.

• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)

• Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers

• Other duties as assigned.

Job Qualifications

Required Education

Bachelor's Degree

Required Experience/Knowledge, Skills & Abilities

10 years of healthcare contact center and operational experience.

10 years of leadership experience with leading large teams.

10 years of experience with leading operations for multiple markets and product lines as well as experience with data analytics, customer experience, workforce management, quality metrics for operations and business/innovative solutions.

Experience developing and managing department budget within prescribed parameters.

Experience with account management responsibilities with senior level leadership.

Experience with Genesys, Salesforce.

Preferred Education

Master's Degree or appropriate relevant healthcare experience

Preferred Experience

Experience implementing process improvements in a matrix environment.

Medicaid and Medicare experience
• PJCC
• LI-AC1

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: $186,201 - $363,093 / ANNUAL
• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Read the full job description and apply online on the recuiter's web-site

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