Director, Member Experience (Process Improvement)

Job Summary

The Director, Member Experience is responsible for developing, implementing, and monitoring a successful strategy to achieve Molina’s Medicaid membership retention goals & objectives across the enterprise for the Medicaid lines of business (TANF, ABD, Expansion, CHIP) including similar solutions for other LOBs (Medicare, Marketplace) as appropriate. This position is accountable for the development of enterprise strategies that lead to membership growth and retention.

The ideal candidate would be curious, enjoy cross functional collaboration, and have a proven track record of creating and implementing successful strategies to improve member/customer satisfaction. This role will be full-time remote and healthcare/pharmacy experience is highly preferred.

Knowledge/Skills/Abilities

• Identify and drive process improvements to enhance the member and provider experience.

• Develop strategies to alleviate pain points in areas such as pharmacy, network and provider relations, pharmacy, and other critical areas the effect overall experience.

• Participates and contributes in Enterprise Health Plan meetings, regarding the overall strategic planning for the health plan.

• Identifies opportunities and helps develop / prioritize initiatives that help with member retention.

• Works closely with the leadership team to ensure that the results of member satisfaction/retention activities are consistent with the state’s direction and objectives, and develops & implements strategies to quickly course correct, when necessary.

• Establishes and reviews performance metrics (“scorecards” and reports) on a regular basis to ensure each health plan is on track to deliver results in line with the organizations strategic plan; provides recognition and recommendation to improve performance.

• Communicates extensively with other Molina departments to ensure policies, programs and strategies achieve membership retention targets.

• Identifies technology support needs that help facilitate member retention and satisfaction activities and drives successful implementation.

Job Qualifications

REQUIRED EDUCATION:

Bachelor’s degree in health-related degree or equivalent experience.

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:

• Minimum 7 years’ experience in Medicaid Managed Care, particularly in sales or outreach role.

• Minimum 3 years management/supervisory experience.

• Exceptional networking and negotiations skills, as well as strong public speaking/presentations skills.

• Ability to work in a fast-paced, team-oriented environment with little supervision.

• Process Improvement (Six Sigma) expertise.

• Proven ability to influence or persuade senior level leaders regarding matters of organizational significance.

• Proven ability to influence policy making.

• Knowledge of applicable State, Federal and third-party regulations.

• Thorough understanding of Medicaid product lines.

• Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

Active State Life and Health and/or Disability License without infraction.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V