Vp, Member Enrollment (Core Ops) - Remote

Job Summary

Under the general direction the SVP, Core Operations is responsible for the strategy, design, and implementation of companywide initiatives impacting Member Enrollment and Core Ops.

Knowledge/Skills/Abilities

• Participates with others in the Corporate Operational Leadership Team along with IT to analyze the root cause of information variations to find/propose ways to improve upon performance results.
• Improves the quality of the services provided, reducing G&A costs as measured by both Unit Costs and on a per member per month basis in each of the areas reporting to this role.
• 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.
• Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.
• Ability to abide by Molina's policies.
• Other duties as assigned.
• Ability to maintain attendance to support required quality and quantity of work.
• Excellent verbal and written communication skills.
• Manages vendors involved in any of the areas reporting to Core Operations to 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.
• Hires and coordinates training, and manages staff involved in creating controls, documents, and tools within the Member Core Ops Team.
• Skill to envision, craft proposals, obtain consensus around approving and implementing future state processes and systems needed to support the strategic direction set by the organization.
• Sets and manages costs to meet/exceed annual budgets set for each of the areas reporting to the VP of Core Ops and finds ways to improve productivity and automation wherever possible.
• Works with the Training Team in preparing needed documentation to train new/existing staff.
• Establishes controls to identify potential risks to the organization and to lead the needed changes within the member enrollment process to support the organizational needs in all lines of business.
• Meeting and exceeding State and Federal regulatory requirements for quality, compliance, and turnaround times.
• Design and implement systematic approach to improve member experiences through increased operational efficiency and effectiveness.
• Ensures Policies/Procedures and SOPs are implemented and followed on a consistent basis to ensure the highest quality and compliance.
• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
• Member enrollment for all lines of business including Medicaid, Medicare, and Marketplace as well as providing overall organizational leadership aimed at managing the intake, outbound and internal processing of member records.

Job Qualifications

Required Education

Bachelor's Degree

Required Experience

Minimum of 10 years Healthcare experience in ENROLLMENT and/or Operational experience.

4 years minimum in Director level role or above.

Accountability for multiple markets or product lines.

Experience developing and managing department budget within prescribed parameters.

Preferred Education

Experience with account management responsibilities with senior level leadership.

Master's Degree or appropriate relevant healthcare experience (with minimum of 7 years for relevant Master's degree)

Preferred Experience

Experience implementing process improvements in a matrix environment.

Salary Pay Range: $161,914 - $315,733 a year*

• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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.

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