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AVP, Member Services

Company: Molina Healthcare
Location: Long Beach
Posted on: March 24, 2020

Job Description:

Job Description

Job Summary

Provides new and existing members as well as providers with the best possible service in relation to general service needs including questions about benefits, billing inquiries, service requests, suggestions and complaints. Resolves member and provider inquiries and complaints fairly and effectively. Provides product and service information to members and providers, and identifies opportunities to increase membership by improving our member and provider experience . Recommends and implements programs to support member and provider needs. Knows and supports Health Plans in achieving their contractual goals for service and compliance.

Knowledge/Skills/Abilities

Provides multi-site, senior leadership and oversight for the Member and Provider Contact Centers to ensure stellar service is delivered according to Molina policies and procedures. Responsible for the overall results of multiple sites and/or lines of business. Directly manages Directors and/or Regional Directors in support of servicing members and providers. Responsible for ensuring teams deliver effective customer service for all service needs including benefits, claims, billing inquiries, service requests, suggestions and complaints. Directly and through team members resolves both member and provider inquiries and complaints fairly and effectively. Provides direction and coordination to deliver accurate product and service information to members and providers, and identifies opportunities to increase membership by improving our member and provider experience. Recommends and implements programs to support member and provider needs. Works within a matrix environment with dotted line relationships across multiple lines of business.

--- Sets a positive example for others and builds our Molina culture by modeling our vision and values in their daily actions.

--- Dynamic leadership for Contact Center management team and agents.

--- Partners with Health Plan, Product, Marketing, ePMO and IT personnel in order to achieve goals and improve the member and provider experience.

--- Strong leader with the ability to develop teams focused on delivering great healthcare service to a population that has often been underserved.

--- Directs and coordinates all aspects of Member and Provider Contact Center operations through partnerships with other teams and departments, as well as development of their own team.

--- Meets and exceeds department KPIs including productivity and service quality goals. Implements strategies to meet/exceed goals and improve customer service.

--- Drives process improvements to ensure performance standard goals including quality goals are met.

--- Participates in audits including state, federal, internal, NCQA and HEDIS as applicable.

--- Provides exemplary customer service to all customers including our members, co-workers, vendors, providers, government agencies, business partners and the general public.

--- Adheres to and displays Who We Are practices to continue to support our Molina culture.

--- Supports Senior Leadership in their goals and objectives.

--- Enhances efficiencies while maintaining quality and culture.

--- Advocates for their teams and internal clients.

--- Maintains budget goals.

--- Ability to present business cases to multiple levels of leadership and front-line staff.

--- Possesses the ability to distill complex issues and situations into a readily understandable item with recommendations for improvement.

--- Demonstrates knowledge of standard call center technology to include telephony, IVR, CRM, QNXT and CTI.

--- Displays a deep understanding of Quality programs and quality improvement.QualificationsJob Qualifications

Required Education

Graduate Degree or equivalent combination of education and experience

Required Experience

15+ years Contact Center Management. Proven leadership success within medium-large contact centers managing multiple people managers. Ability to work within matrixed environment with dotted line responsibilities. Strong collaboration and communication skills.

Preferred Education

Graduate Degree or equivalent combination of education and experience

Preferred Experience

10+ years experience in the Healthcare industry.

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.

Keywords: Molina Healthcare, Long Beach , AVP, Member Services, Other , Long Beach, California

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