Molina Healthcare Mgr, Member Engagement, Quality (Remote) in HOUSTON, Texas

December 1, 2023

Job Description


Molina Healthcare is hiring for a Manager, of Member Engagement, Quality . This role is remote and can be worked from any location within the US.

The Mgr, Member Engagement will be responsible for continuous quality improvements regarding member engagement and member retention. Represents Member issues in areas involving member impact and engagement including Appeals and Grievances, Member Problem Research and Resolution, and the development/maintenance of Member Materials.

Highly qualified candidate will have the following experience:

  • Call Center/Contact Center Leadership, Manger, or Supervisory role, managing a team including (but not limited to) hiring, training, assigning work, and managing the performance of staff.

  • Background and understanding of Quality and Quality measurements in the Managed Care arena.

  • Ability to analyze data to generate valuable insights to identify issues, predict trends and make recommendations on process and policy improvements from reports.

KNOWLEDGE/SKILLS/ABILITIES

  • Under general direction, identifies and initiates continuous quality improvements regarding member engagement and member retention.

  • Manages and develops a team focused on meeting or exceeding established performance targets. Targets may be based upon plans, federal or state requirements as dictated.

  • Proactively plans for daily priorities as well as responds to new priorities within the organization and opportunities assigned from upper management.

  • Collaborates with operational areas involving member impact and engagement including Appeals and Grievances, Member Inquiry Research and Resolution, and development/maintenance of Health Plan and, specifically, Member Materials.

  • May serve as liaison from Health Plan to the Contact Center and Enrollment/Membership Accounting in the absence of director.

  • May serve as liaison from Health Plan to Medicare Appeals and Grievances and Medicare/MMP Member Materials in absence of the director.

  • Represents Member issues on the Plan’s Senior Leadership Team.

JOB QUALIFICATIONS

Required Education: Bachelor’s Degree or equivalent combination of education and experience

Preferred Education: Graduate degree or equivalent combination of education and experience

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.

Key Words: Medicare, Medicaid, Managed Care, MCO, Call Center, Contact Center, Quality, Analyst, Analyze, Quality Assurance, Active Listening, Communication, Compliance, Adherence, Documentation, Regulation, Customer Satisfaction, Problem Resolution, Satisfaction Scores, KPI, Training, Metrics, AHT, CSAT, FCR

Pay Range: $59,810.6 – $129,589.63 / ANNUAL

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









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