• VP, Network Performance & Effectiveness

    Molina Healthcare (Racine, WI)


    Job Description

    Job Summary

    Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, performance, and adequacy, along with provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. The VP, Network Performance and Effectiveness role is responsible for the ongoing improvement of key performance indicators across all markets and service segments. Owns the assessment of network performance and identification of opportunities, and partners with market leadership to develop and execute on improvement plans, under the direction of the SVP of Network Strategy and Services.

    Job Duties

    + Lead Program Director team, managing all aspects of team’s mission and deliverables.

    + Develop market-specific improvement plans and drive priorities based on the analysis of available performance data.

    + Partner with market and segment leaders and subject matter experts in the implementation of best practices across local health plans.

    + Lead market performance improvement initiatives (SAIs, annual unit cost budgeting, etc.).

    + Present performance strategies and updates to senior leadership, providing critical transparency to program initiatives.

    + Work closely with health plans leadership to ensure compliance with all Molina, regulatory and industry standards.

    + Responsible for the continued development and enhancement of the Provider Network Management and Operations Department including the implementation of standard processes, policies and procedures.

    + Support and execute new health plan implementations, acquisitions and expansions in collaboration with the Business Development Team.

    + Drive positive cultural changes with focus on coaching and development.

    Job Qualifications

    **REQUIRED EDUCATION** :

    Bachelor’s Degree in Business Administration or a related field or equivalent experience

    **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :

    + Minimum 10+ years of management and strong leadership experience.

    + Minimum 5 years of healthcare, managed care, provider services and call center operations experience in government sponsored programs.

    + Excellent interpersonal and verbal and written communication skills.

    + Excellent leadership and managerial skills.

    **PREFERRED EDUCATION** :

     

    Master’s Degree

     

    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: $214,132 - $417,557 / ANNUAL

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