The VP, Encounters is responsible for the Encounters function for all lines of business and reports to the SVP, Corporate Operations. This executive role leads and oversees all encounters operations and major initiatives aimed at ensuring optimal encounter submissions performance for Molina.

Key Responsibilities

• Implements strategies to ensure effective encounter submissions that comply with all state, CMS, and HHS rules

• Monitors business processes, systems, and vendors that facilitate encounter submissions for all lines of business

• Maintains adherence to encounters compliance standards, including all state, federal and Molina regulations; keeps Policies, Procedures, and SOPs up to date, and ensures they are consistently applied to maintain the highest levels of compliance

• Establishes and improves operational reports to monitor operations and take action for best results

• Leads system-wide improvements to fix and prevent frequently occurring encounter errors

• Drives creative solutions and innovation to enhance overall encounters performance

• Leads Molina employees and supervises vendors engaged in any of the areas under the VP, Encounters to achieve operational outcomes at the minimal cost, with compliant service standards and at the highest level of quality for all lines of business

• Collaborates closely with executive peers and internal teams such as Recovery, Claims, Compliance, Support Services, IT, Enrollment, and Network, and offers leadership to the organization to achieve the best encounter outcomes aligned with business priorities and strategic goals

• Finds opportunities to lower administrative expenses for Molina and/or providers through projects and initiatives

• Initiates staff and coordinates needed projects for various systems enhancements, conversions, and upgrades

• Convenes work groups, develops implementation plans with identified tasks, timelines, and assignments. Executes and measures success.

• Leads, mentors, and oversees teams that build controls, documentation, and tools that support Encounters business processes

• Identifies, develops, and establishes staff training plans on end-to-end processing and management of encounters

• Sets and manages overall costs to meet/exceed annual budgets and finds ways to improve productivity and automation wherever possible to reduce unit costs and overall G&A for the organization

• Responsible for reporting potential liabilities for financial tracking and accruals to senior leadership.

Skills

• Excellent verbal and written communication skills

• Ability to influence and drive change among peers and others within the Molina organization

• Skill to envision, craft proposals and business cases, obtain consensus around approving and implementing future state processes and systems needed to support strategic direction set by the organization

• Ability to abide by Molina's policies

• Ability to maintain attendance to support required quality and quantity of work.

• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).

• Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers, and customers.

• Other duties as assigned

Job Qualifications

Required Education

Bachelor's Degree or equivalent experience

Required Experience

• Minimum of 10 years Healthcare experience in related job or Operational experience

• 4 years minimum in Director level role or above.

• Accountability for multiple markets or product lines

• Experience developing and managing department budget within prescribed parameters

• Experience with account management responsibilities with senior level leadershipTo 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: $161,914.25 - $315,732.79 / ANNUAL

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