Director, Member Experience (Process Improvement) - REMOTE

About the Role

This position is responsible for developing, implementing, and monitoring a successful strategy to achieve Molina’s Medicaid membership retention goals and objectives across the enterprise for the Medicaid lines of business (TANF, ABD, Expansion, CHIP), including similar solutions for other lines of business (Medicare, Marketplace) as appropriate. The role is accountable for the development of enterprise strategies that lead to membership growth and retention. This is a full-time remote position, and healthcare/pharmacy experience is highly preferred.

Responsibilities

• 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, and other critical areas that affect overall experience.
• Participate and contribute in Enterprise Health Plan meetings regarding the overall strategic planning for the health plan.
• Identify opportunities and help develop/prioritize initiatives that aid in member retention.
• Work closely with the leadership team to ensure member satisfaction/retention activities align with the state’s direction and objectives, and develop/implement strategies to course-correct when necessary.
• Establish and review performance metrics (scorecards and reports) regularly to ensure each health plan delivers results in line with the organization’s strategic plan; provide recognition and recommendations to improve performance.
• Communicate extensively with other Molina departments to ensure policies, programs, and strategies achieve membership retention targets.
• Identify technology support needs that facilitate member retention and satisfaction activities and drive successful implementation.

Requirements

• Bachelor’s degree in a health-related field or equivalent experience.
• Minimum 7 years’ experience in Medicaid Managed Care, particularly in sales or outreach roles.
• Minimum 3 years of management/supervisory experience.
• Exceptional networking and negotiation skills, as well as strong public speaking and presentation 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 on 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 Qualifications

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

Pay

Pay Range: $96,325.57 – $208,705.40 per year. Actual compensation may vary based on geographic location, work experience, education, and/or skill level.