Job Description

Job Duties

• Ensures compliance with all contractual, State and Federal performance standards of Molina's most complex and high-risk, high maintenance delegated subcontractors which provide covered services and administer benefits across multiple States;

• Review of performance reports and monitor key performance indicators (KPIs) to ensure compliance with contractual and regulatory service level agreements (SLAs)

• Administration of corrective action plans (CAPs) to remediate delegated subcontractor deficiencies

• Assess financial penalties on delegated subcontractors in accordance with contractual requirements

• Performs detailed analysis of National and State delegated vendor contracts on behalf of the department to ensure that all contractual requirements and performance metrics for which the department has responsibility to oversee have been accurately identified and recorded for effective monitoring and oversight

• Assists department Director in standardization of State delegation oversight and performance management SOPs and activities

• Administration of change management process

• Compilation and presentation of delegated subcontractor performance metrics at quarterly Delegation Oversight Committee meetings

• Reviews/analyzes data by applying job knowledge and experience to ensure appropriate information has been provided

• Develops and maintains detailed project plans to include milestones, tasks, and target/actual dates of completion

• Build strong partnership with Health Plan leaders, business owners, SMEs and other internal department staff

• Assist with the collection of documentation from multiple sources in preparation for internal and regulator audits

Job Qualifications

REQUIRED EDUCATION:

Bachelor’s Degree or equivalent combination of education and experience

REQUIRED EXPERIENCE:

• 5+ years’ experience that includes demonstrated track record of accomplishments overseeing more complex delegated subcontractors/subcontractors straddling multiple States and/or LOBs or equivalent related experience

• Proficient in reviewing and understanding delegated vendor contracts

• Strong problem-solving, root cause analysis, and process improvement skills

• Excellent communication skills, time management, organizational and prioritization skills

• Ability to manage multiple stakeholders and competing priorities

PREFERRED EDUCATION:

Masters of MBA

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

PMP or Six Sigma Green Belt certification

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.

Pay Range: $54,373 - $107,808 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.