Job Description - VP, Core Operations (2003293)
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
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VP of Corporate Operations is responsible forthe strategy,
design, and implementation of companywide initiatives impacting
Enrollment,Premium Billing and Reconciliation for all lines of
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
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
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
Convenes work groups, develops implementationplans with
identified tasks, timelines and assigned parties. Executes
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.
Meet or exceed state regulatory requirements
Ability to improve the quality of our providerand member
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
Minimum of 7 years Healthcare operations 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
Molina Healthcare offers a competitive benefits and compensation
package. Molina Healthcare is an Equal Opportunity Employer (EOE)