JOB DESCRIPTION
Job Summary
Responsible for continuous quality improvements regarding member engagement and member retention. Represents Member issues in areas involving member impact and engagement including: Appeals and Grievances, Member Problem Research and Resolution, and the development/maintenance of Member Materials.
KNOWLEDGE/SKILLS/ABILITIES
- Under general direction, identifies and initiates continuous quality improvements regarding member engagement and member retention.
- Manages and develops a team focused on meeting or exceeding established performance targets. Targets may be based upon plans, federal or state requirements as dictated.
- Proactively plans for daily priorities as well as responds to new priorities within the organization and opportunities assigned from upper management.
- Collaborates with operational areas involving member impact and engagement including: Appeals and Grievances, Member Inquiry Research and Resolution, and development/maintenance of Health Plan and, specifically, Member Materials.
- May serve as liaison from Health Plan to the Contact Center and Enrollment/Membership Accounting in the absence of director.
- May serve as liaison from Health Plan to Medicare Appeals and Grievances and Medicare/MMP Member Materials in absence of the director.
- Represents Member issues on the Plan's Senior Leadership Team.
- Medicare experience
JOB QUALIFICATIONS
Required Education
Bachelor's Degree or equivalent combination of education and experience
Preferred Education
Graduate degree or equivalent combination of education and experience
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.
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