VP, Member & Provider Support Center Services (Remote)

About the Role

Provides executive-level strategy and leadership to the team responsible for member and provider services support center operations. Develops and drives strategies to optimize operational excellence, support growth, and increase member and provider satisfaction. Ensures functional operations, contractual compliance, and alignment with member satisfaction, retention, quality, and financial goals.

Responsibilities

• Supports executive strategy development, vision, and direction for the member and provider support center services function.
• Demonstrates accountability for performance and financial results, keeping executive leadership apprised.
• Oversees all member and provider support center services activities, including workforce management, reporting, quality assurance, business solutions, vendor performance, and telephony across Medicaid, Medicare, and Marketplace lines of business.
• Develops and drives strategies that support growth and increase member and provider satisfaction.
• Builds and maintains strong relationships with internal and external stakeholders to ensure optimal shared services delivery.
• Ensures seamless integration of newly acquired employees, including scope of work and structure.
• Identifies projects/initiatives to reduce administrative costs and introduce innovative solutions; convenes work groups, develops implementation plans, and executes and measures success.
• Leads direct Molina staff and oversees vendors to produce operational results at the lowest possible cost, consistent service levels, and the highest quality for all lines of business.
• Ensures compliance with all state, federal, and Molina regulations, policies, procedures, and SOPs within the support center function.
• Manages overall costs to meet or exceed annual budgets and improves productivity and automation to reduce unit costs and G&A expenses.
• Designs and implements systematic approaches to improve member and provider experiences through increased operational efficiency.
• Reports potential liabilities for financial tracking and accruals to senior leadership.
• Hires, trains, develops, and manages the team, demonstrating accountability for performance and achievement of department-specific goals.
• Models dynamic leadership, focusing the team on delivering great healthcare and customer service to underserved populations.

Requirements

• At least 12 years of healthcare operations and/or contact/call center experience, including managing large matrixed teams, or equivalent combination of relevant education and experience.
• At least 7 years of management/leadership experience.
• Experience leading operations for multiple markets and product lines.
• Data analytics, customer experience, workforce management, and quality metrics experience supporting operations and business solutions.
• Experience developing and managing a department budget within prescribed parameters.
• Experience with account management responsibilities at the senior leadership level.
• Understanding of Medicare, Medicaid, and Marketplace plans.
• Experience with Genesys/Salesforce.

Skills

• Ability to influence and drive change among peers and across the organization.
• Skill in envisioning, crafting proposals, and obtaining consensus for future state processes and systems.
• Demonstrated adaptability and flexibility to change and new ideas.
• Strong organizational and time management skills; ability to manage simultaneous projects and tasks to meet deadlines.
• Ability to establish and maintain positive work relationships with coworkers, clients, members, providers, and customers.
• Ability to work cross-collaboratively in a highly matrixed organization and maintain effective relationships with stakeholders.
• Excellent verbal and written communication skills.
• Proficiency in Microsoft Office suite (including Excel) and applicable software programs.

Preferred Qualifications

• Experience implementing process improvements in a matrixed environment.
• Managed care experience.

Pay

Pay Range: $214,131 - $417,556 / annual. Actual compensation may vary based on geographic location, work experience, education, and/or skill level.