COO, Health Plan (Ohio) (Columbus)

Job DescriptionJob Summary
Responsible for the overall direction and administration of the operational departments, programs and services provided by the health plan. Responsibilities include: implementing programs that are in alignment with Molina's strategic plan and operating plan; providing day-to-day leadership and management of the health plan operations that mirrors the company's mission, vision, and core values; and 
ensure 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 - OhioKnowledge/Skills/Abilities
Duties and Responsibilities (List all essential duties and responsibilities in order of importance) 
• Serve as Health Plan point of contact 
• Ensure all Shared Service areas and Functions understanding priorities and issues for the Health Plan. 
• Collaborate with Shared Services to ensure they understand and are fulfilling Health Plan requests and commitments 
• Formulate and implement business plans, tactics and strategies to provide for the efficient, effective and compliant operations to meet short-term objectives/obligations and ensure long term growth and success. 
• Develop and implement adequate measures to meet the operational needs of the company, to efficiently utilize its resources, and to maintain an effective system of operational processes & 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: 
• o Increase claims payment accuracy and auto-adjudication 
• o Increase members and provider satisfaction 
• o Identify and implement cost savings initiatives in contracting, operations and employee productivity 
• o Avoid work-arounds and unplanned re-work. 
• Ensure the overall level of quality for operational and contractual obligations meet or exceed 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 (List all essential duties other than those listed above in order of importance) 
• Overall management of various departments/functions in multiple office locations which could include: 
o Network Management and Operations 
o Health Plan Operations 
o Other Functional Areas as Needed 
• Other duties: 
o Project Management 
o Represent the Health Plan on various committees and work groups within the Shared Services Team 
o Other duties as requested 
o 
o Operational and Communication work groups 
o 
o Project Management 
o Represent Health Plan on MHI Committees or Operational workgroups (e.g., VPs of Network Management monthly meeting, MHI Ops Quarterly meeting with Health Plan, etc.) 
o Other functional areas as needed. Job QualificationsRequired Education
Bachelors' degree in Business, Health Services Master's Degree in Business, Policy, Public Administration or Health Services Administration or related field.Required Experience
15-plus year's progressive healthcare experience. Direct experience in the managed care industry; 10+ years of managed care with Medicaid and Medicare managed care plans. Management experience.Preferred Education
Master's or PhD Degree in public health, social or behavioral services or similar disciplinePreferred Experience
10+ years in public health, social or behavioral services, or similar field; 3+ years in a direct or matrix leadership position
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.Full timePosting Date: 2026-07-21