AVP, Medicare Duals Optimization (REMOTE)

Molina Healthcare; Columbus (OH); Remote; USD 140,000 - 275,000; Full time

Job summary

A leading healthcare organization in Columbus, Ohio seeks an experienced professional to provide leadership and strategic direction for integrated duals programs. The ideal candidate will have extensive experience in Managed Care and Medicare operations, demonstrating strong leadership skills and proficiency in MS Office. This role offers a competitive salary between $140,795 and $274,550, focusing on operational performance and compliance within dual product offerings.

Benefits

Competitive benefits and compensation package

Qualifications

• At least 10 years’ experience in Managed Care, specifically government programs.
• Strong leadership in a matrixed environment.
• Experience analyzing technical performance.
• Proficiency in MS Office Tools.

Responsibilities

• Supports strategy development for integrated duals business.
• Leads integrated duals product development.
• Coordinates accountabilities to drive operational performance.
• Collaborates on growth opportunities with leadership.
• Directs analytical activities to identify trends.

Skills

Managed Care Experience

Leadership Skills

Adaptability

Analytical Skills

MS Office Proficiency

Education

Equivalent combination of education and experience

Tools

MS PowerPoint

MS Excel

Job description

Overview

Job Description

Job Summary

Provides leadership to a team that is responsible for strategy, process improvements, and operational support to advance the goals and objectives of the Integrated Duals program. Supports integrated duals product development in collaboration with enterprise and health plan teams. Supports integrated teams in continual process improvement, identifying opportunities, driving projects and implementation efforts around enhanced/new processes. Partners with health plans and other enterprise teams to effectively manage and implement integrated dual products. Supports Go-To market planning for integrated duals. In partnership with other members of the Office of Duals, members of the market leadership team, responsible for optimizing operational departments, programs, and services in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state, and local regulatory requirements.

Responsibilities

• Supports strategy development, vision and direction for integrated duals overall business and strategic objectives.

• Serves as a duals SME for enterprise and health plan teams in developing Go-To market strategies.

• Leads and supports integrated duals product development and benefit strategy for markets.

• Supports development of duals specific training.

• Coordinates accountabilities between duals office and markets to drive operational performance.

• Coordinates accountabilities between duals office and shared service to drive compliance and efficiency as well as provide oversight, including service level agreements.

• Collaborates with Medicaid business development and market leadership on mutual growth opportunities.

• Works with senior management to mitigate risk and develop/implement improvements for all operational areas that impact duals performance.

• Collaborates with compliance to ensure appropriate oversight/internal audits; develop leading indicators and alerts for all key operational metrics.

• Directs analytical activities to identify trends and potential opportunities.

• Formulate and implement business plans, tactics, and strategies to provide for efficient, effective, and compliant operations to meet short-term objectives/obligations and ensure long term growth and success.

• Works with Legal Affairs to assess and provide analyses for proposed changes to Medicare, and other government-sponsored healthcare program contracts, governing regulations and new legislation and policy requirements.

• Directs managers and/or directors of specific functional areas as assigned.

• Serves as Chief of Staff for Duals Leader.

Qualifications

REQUIRED QUALIFICATIONS:

• At least 10 years’ experience in Managed Care, specifically government programs and/or Medicare/Duals Health Plan Operations or equivalent combination of education and experience.

• Strong leadership in a matrixed environment

• Demonstrated adaptability and flexibility to a rapidly moving business environment.

• Background analyzing technical performance and driving teams to improvement via direct management and oversight.

• Strong proficiency in MS Office Tools, particularly PowerPoint and Excel.

PREFERRED QUALIFICATIONS:

• Experience with Medicare SNP Plans.

• Experience with continuous process improvement strategies

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.

Pay Range: $140,795 - $274,550 / ANNUAL

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