Be an early applicantLess than 25 applicantsPosted by Agency

Company

Molina Healthcare · 3 hours ago

Dir, Medicare Segment Optimization

Arizona, United States

Full-time

Remote

Director/Executive

$107K/yr - $250K/yr

5+ years exp

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H1B Sponsor Likely

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Responsibilities

Under the leadership of the VP Medicare Segment Lead, this role will facilitate transparent and compliant execution of Medicare performance objectives.

Coordinates accountabilities between segment and markets to drive performance in network, risk adjustment, and stars; single point of contact for escalations from aligned market segments.

Coordinates accountabilities between segment, health plans, and shared services to drive compliance and performance objectives as well as provide oversight, including service level agreements.

Works with staff and senior management to mitigate risk and develop/implement improvements across areas that impact Medicare performance.

Collaborates across Medicare segment, with health plans, and enterprise shared services to ensure appropriate performance objectives are met; develop leading indicators and alerts for all key operational metrics.

Analyzes activities and identifies trends and potential opportunities within Medicare segment to achieve performance objectives at a state and overall level.

Develop ownership and outcome recommendation for processes that cross functions – segment, enterprise operations, etc.

Direct implementation, monitoring, and measurement of strategic and tactical plans that contribute to segment and health plan growth and achievement of other performance objectives.

Other operational duties as assigned by the Segment Lead.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Managed CareMedicare OperationsMS Office ToolsData AnalysisSNP PlansMMP Plans

Required

Bachelor's Degree in Business, Health Services Administration or related field, or comparable experience.

5-10 years’ experience in Managed Care, specifically government programs and/or Medicare/Duals Health Plan Operations

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

Graduate Degree

Experience with SNP and MMP Plans

Company

Molina Healthcare

Glassdoor

3.4

Molina Healthcare is a healthcare company that specializes in government-sponsored healthcare programs for families and individuals.

Founded in 1980

Long Beach, California, USA

10,001+ employees

https://careers.molinahealthcare.com

H1B Sponsorship

Molina Healthcare has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2023 (33)

2022 (36)

2021 (33)

2020 (60)