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Molina Healthcare

VP, Network Mgmt & Ops (Ohio Health Plan)

Molina Healthcare, Columbus, Ohio, United States, 43224

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VP, Network Mgmt & Ops (Ohio Health Plan)

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Molina Healthcare

Job Summary Molina Health Plan Operational Leadership roles provide overall direction and administration of the Plan's operational departments, programs, and services.

Responsibilities

Implement programs aligned with Molina Healthcare's strategic and operating plan.

Provide day-to-day leadership and management of the health plan market or product operations, reflecting the company's mission, vision, and core values.

Ensure efficient and compliant operations of the market or product of the health plan.

Develop and implement provider network and contract strategies.

Oversee provider credentialing, delegation oversight, and network administration activities.

Serve as the primary liaison for Claims, Member Services, and other departments.

Negotiate provider contracts and oversee contract management.

Contribute to strategic planning as a member of the Senior Leadership Team.

Manage provider contract information, fee schedules, and rates.

Oversee Provider Services and Provider Network Administration.

Qualifications Required Education Bachelor's Degree in Business, Health Services Administration, or related field.

Required Experience

10+ years in Healthcare Administration, Managed Care, or Provider Services.

Experience managing employees.

Strong analytical, problem-solving, and research skills.

Preferred Education Master's Degree in Business, Health Administration, or related field.

Preferred Experience Experience with Medicaid and Medicare managed care plans.

Additional Information This is a full-time executive role with a salary range of $186,201.39 - $363,093 annually. Molina Healthcare is an Equal Opportunity Employer. Current employees should apply through the intranet.

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