VP, Core Operations

Company: Molina Healthcare
Location: Long Beach
Posted on: September 12, 2020

Job Description:

Job Description - VP, Core Operations (2003293)

Job Description

VP, Core Operations - ( 2003293 )

Primary Location : US-CA-Long Beach-LB6TH

Job : Core Operations

Organization : Corporate

Job Posting : Jul 11, 2020, 3:17:20 AM

Additional Information : To learn more about Molina Healthcare Careers, follow us on LinkedIn , Twitter  & Facebook . You can also visit Molina Cares to view interactive tutorials on resume & cover letter writing, interviewing and more!

Knowledge/Skills/Abilities

VP of Corporate Operations is responsible forthe strategy, design, and implementation of companywide initiatives impacting Enrollment,Premium Billing and Reconciliation for all lines of business.

Identifies, develops and trains appropriatestaff and implements processes to standardize the overall end-to-end process.

Hires, coordinates training and manages staffinvolved in creating controls, documents and tools within the Corporate Enrollment,Premium Billing and Reconciliation or other Corporate Operations areasreporting to the SVP, Corporate Operations, in order to manage work in any of the assignedCorporate Operations areas for all lines of business.

Ensures the accurate and timely completion ofall Enrollment, Billing and Reconciliation functions for all lines ofbusiness. This includes working with the IT team to ensure systemefficiency in processing enrollment files received from regulatoryagencies.

Oversee the development and maintenance of outboundeligibility extracts to vendors, providers and agencies as necessary to supporthealth plan operations.

Ensures all state, federal, and Molinaregulations, Policies/Procedures and SOPs are implemented and followed on aconsistent basis to provide the highest compliance possible

Ensures ID cards, welcome kits, membercommunications including invoices are processed and send out timely to meetregulatory requirements.

Facilitate initiatives at the enterprise levelto improve the member/provider experience in areas such as PCP assignments, calldriver reduction, COB optimization etc.

Identifies, develops and implements processesto standardize exception handling

Collaborates with IT to enhance/automateprocesses including the use of BOT process as needed to reduce manualintervention.

Initiate and coordinate needed projects aroundvarious systems enhancements, conversions, growth/expansion and upgrades.

Identifies projects/initiatives that reduceadministrative costs.

Convenes work groups, develops implementationplans with identified tasks, timelines and assigned parties. Executes andmeasures success.

Lead meetings with IT to analyze the rootcause of member data variance/issues and propose ways to improve.Identify potential risks to the organizationand to lead the needed systems or configuration changes within the core systemto support the organizational needs in all lines of business.

Establish and manage annual budgets for the Enrollment/PremiumBilling and Recon department while finding ways to improve productivity andautomation to reduce unit costs and overall G&A for the organization.

Other duties

Meet or exceed state regulatory requirements

Ability to improve the quality of our providerand member experience

Ability to drive positive operational andfinancial outcomes

Excellent verbal and written communicationskill

Ability to influence and drive change amongpeers and others within the Molina organization

Skill to envision, craft proposals, and obtainconsensus around approving and implementing future state processes and systemsneeded to support the strategic direction.

Maintain confidentiality and comply withHealth Insurance Portability and Accountability Act (HIPAA)

Ability to establish and maintain positive andeffective work relationships with coworkers, clients, members, providers andcustomers

JobQualifications

Required Education

Bachelor'sDegree

Required Experience

Minimum of 7 years Healthcare operations experience

Preferred Education

Master's Degree

Preferred Experience

Minimum of 3 years Healthcare Enrollment and Billing experience with Medicaid,Medicare and Marketplace

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 , VP, Core Operations, Other , Long Beach, California