COO, Health Plan (Ohio)

Job Summary Responsible for the overall direction and administration of the operational departments, programs and services provided by the health plan. Responsibilities include implementing programs in alignment with Molina's strategic and operating plans; providing day‑to‑day leadership and management of the health plan operations that mirrors the company's mission, vision, and core values; and ensuring the efficient and compliant operations of the health plan. Specific areas of responsibility can include Provider Network Management (Contracting, Provider Services, Operations), Member Services/Appeals & Grievances, Community Engagement, Project Management, and Remote Office leadership and guidance. Preferred Work Location Ohio Knowledge, Skills, and Abilities Serve as Health Plan point of contact Ensure all Shared Service areas and Functions understand priorities and issues for the Health Plan. Collaborate with Shared Services to ensure they understand and fulfill Health Plan requests and commitments Formulate and implement business plans, tactics and strategies to provide efficient, effective, and compliant operations to meet short‑term objectives and obligations and ensure long‑term growth and success. Develop and implement adequate measures to meet the operational needs of the company, efficiently utilize its resources, and maintain an effective system of operational processes and outcome measurement. Create new policies and amend existing policies to improve operations as needed. Present reports and recommendations on the operations of the state plan and propose changes to major policies. Identify and drive new initiatives to optimize systems' performance and leverage functionality to Increase claims payment accuracy and auto‑adjudication Increase members and provider satisfaction Identify and implement cost savings initiatives in contracting, operations and employee productivity Avoid work‑arounds and unplanned re‑work Ensure the overall level of quality for operational and contractual obligations meets or exceeds appropriate standards. Provide personal leadership that encourages employee productivity and responsiveness to the needs of the current and prospective members, providers and regulatory agencies/staff. Ensure programs are established to comply with all relevant federal, state and local regulations. State Plan / Department Specific Duties and Responsibilities Overall management of various departments/functions in multiple office locations which could include: Network Management and Operations Health Plan Operations Other functional areas as needed Other duties: Project Management Represent the Health Plan on various committees and work groups within the Shared Services Team Other duties as requested Operational and Communication work groups Represent Health Plan on MHI Committees or operational workgroups (e.g., VPs of Network Management monthly meeting, MHI Ops Quarterly meeting with Health Plan) Other functional areas as needed Job Qualifications Required Education : Bachelor's degree in Business, Health Services. Master's Degree in Business, Policy, Public Administration or Health Services Administration, or related field. Required Experience : 15‑plus years progressive healthcare experience. Direct experience in the managed care industry; 10+ years in Medicaid and Medicare managed care plans. Management experience. Preferred Education : Master's or PhD Degree in public health, social or behavioral services or similar discipline. Preferred Experience : 10+ years in public health, social or behavioral services, or similar field; 3+ years in a direct or matrix leadership position. Pay Range $214,132 - $417,557 / annual. Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. #J-18808-Ljbffr Molina Healthcare