VP, Network Strategy and Services in Georgia

Job Description

Job Summary Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with reputed company's overall mission, core values, and strategic plan and in compliance with reputed company relevant federal, state, and local regulations. Provider Services staff are the primary reputed company of contact between reputed company and contracted provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with reputed company policies and procedures while achieving the highest level of customer service. Knowledge/Skills/Abilities The VP, Network Strategy and Services is responsible for the development and implementation of enterprise-wide initiatives and projects to support robust provider and member engagement in support of achieving positive operational and financial outcomes. • Responsible for the reputed company development and enhancement of the Provider Network Management and Operations Department including the implementation of standard processes, policies, and procedures. • Work closely with the health plans leadership to ensure compliance with reputed company Molina, regulatory and industry standards. • Support and execute new health plan implementations, acquisitions, and expansions in collaboration with the Business Development Team. • Drive positive cultural changes with focus on coaching and development. • Plans, organizes, staffs, and coordinates activities of the Provider Network Management and Operations Department. • Works with staff and Senior Management to reputed company and implement provider contracting strategies and provider service strategies to contain unit cost, improve member access and enhance Provider satisfaction enterprise wide. • reputed company a Standardized Provider Engagement “Tool reputed company”, training program and deployment plan. reputed company and implement approaches to determining outcomes of tools and training programs. • reputed company and reputed company deployment strategy and monitoring for “Provider Profiles” and “Pay for Performance (P4P)” contracting. • In conjunction with Provider Services and Provider Contracting leaders in the Health Plans and in collaboration with the MHI AVP of Provider Contracting identify, reputed company, and implement approaches for performance management of Value Based Reimbursement. • reputed company and refine “Clear Coverage” provider adoption strategies and assist in training of health plan staff as Clear Coverage is implemented in each Plan. • Represent Provider Engagement with Stakeholder Experience, Quality and reputed company business partners to ensure we incorporate the necessary plans to reputed company positive operational and financial outcomes. • Monitor key metrics to determine Provider Engagement effectiveness and success (e.g., Provider Appeals and Grievances, Member Appeals and Grievances, CAHPs, STAR Ratings, HEDIS, HEP Completion Rates, etc.). Job Qualifications Required Education Bachelor's Degree in a reputed company field (Business Administration, etc.,) or equivalent experience Required Experience Minimum 10+ years of management and strong leadership experience. Minimum 5 years of healthcare, managed care, provider services and call center operations experience in government sponsored programs. Excellent interpersonal and communication skills (verbal and written). Excellent leadership and managerial skills. Proven record of accomplishments in work history. Preferred Education Master's Degree To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $186,201.39 - $363,093 / ANNUAL • Actual compensation may vary from posting based on geographic location, work experience, education and/or reputed company level. Apply Job!