is incentive eligible. Introduction Do you have the career opportunities as a Senior Manager Capital Equipment WFH you want with your current employer? We have an exciting opportunity for you to join HealthTrust which is part of the nations leading provider of healthcare services, HCA Healthcare.
Benefits
Work from Home offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
* Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
* Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
* Free counseling services and resources for emotional, physical and financial wellbeing
* 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
* Employee Stock Purchase Plan with 10% off HCA Healthcare stock
* Family support through fertility and family building benefits with Progyny and adoption assistance.
* Referral services for child, elder and pet care, home and auto repair, event planning and more
* Consumer discounts through Abenity and Consumer Discounts
* Retirement readiness, rollover assistance services and preferred banking partnerships
* Education assistance (tuition, student loan, certification support, dependent scholarships)
* Colleague recognition program
* Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
* Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.
Learn more about Employee Benefits
Note: Eligibility for benefits may vary by location.
Our teams are a committed, caring group of colleagues. Do you want to work as a Senior Manager Capital Equipment WFH where your passion for creating positive patient interactions is valued? If you are dedicated to caring for the well-being of others, this could be your next opportunity. We want your knowledge and expertise!
Job Summary and Qualifications
As the Senior Director of Capital Equipment, you are responsible for leading, developing and implementing a strategic capital equipment expense management program for a multifacility integrated delivery network (IDN.) This position is responsible for reviewing and optimizing the current GPO contract portfolio. The Sr. Director will collaborate with the HealthTrust contracting team to lead strategic sourcing initiatives and contract negation as applicable. This position is responsible for building strategic alliances with those stakeholders as it relates to a successful capital equipment expense management program.
In this role you will work with IDN Leadership, Facility Leadership, Clinical Directors, Physicians, Chief Medical Officers, Regional Value Analysis leaders, HealthTrust National and Custom Contracting teams and SolutionsTrust.
Responsibilities
* Provides leadership in the area of capital equipment expense management to contribute to the facility or IDNs overall strategic plan especially as it relates to capital process {including routine capital as well as construction/renovation and clinical initiatives {i.e., surgical initiatives)).
* Assess and provide leadership in the area of capital equipment expense to guide and support organizations strategy.
* Assimilates information from variety of sources, able to analyze data, make strategic recommendations and execute a course of action for capital equipment savings opportunities
* Develops, implements, and coordinates within the hospital or system: A systems approach to capital equipment process and planning that includes but not limited to understanding customers capital inventory and developing an end of life/replacement plans, which includes service/maintenance strategies, Policies and procedures related to capital equipment management that includes budgeting, planning, acquisition, management, and disposition. Evaluates equipment standardization opportunities Participates in development of the agenda, follow up on action items assigned through the Regional Value Analysis Teams, Coordination with GPO National and Custom Contracting team
* Negotiates custom contracts, as applicable, for the cardiovascular categories
* Responsible for managing customer expectations and delivering capital equipment cost savings according to: Estimated timelines, Minimizing overlap of focus with contracts already negotiated or those in process by the contracting team, and coordinates the capital equipment process, supervises data analysis, and use customer participation in the process to achieve goals and objectives
* Interacts and develops relationships with internal and external stakeholders to better understand needs and challenges which may include clinicians, physicians, supply chain, and hospital leadership
* Continuously defines and improves customer solutions as it relates to capital equipment processes and planning
* Provides educational opportunities to customers to understand capital equipment process and planning
* Builds and maintains strong, effective working relationships with a variety of stakeholders within HealthTrust, Supply Chain, organizations leadership, and Regional Value Analysis Teams.
* Establishes and meets expense savings goals for customers as requested.
* Collaborates with organizations to track and analyze financial data
* Provides saving enhancement strategies for capital equipment working with customers representatives and HealthTrust capital equipment contracting team such as developing and executing bulk buy strategies, or participation in HealthTrust Group Buy Program
* Develops standardized documents, processes, and calculations for use by the team to quantify capital equipment savings solutions.
* Directs multiple projects and tasks in a fast paced environment that includes: Strong organizational skills, including the ability to plan, implement, and execute the ability to focus and execute exceptional time management
* Demonstrates the ability to develop a project plan for major and complex projects.
* Develops milestones for projects to determine outcomes are achieved that includes facilitating customer teams that lead to building consensus and contract implementation.
* Assign goals to direct report as appropriate and monitors goal achievement.
* Demonstrates strong medical capital equipment process knowledge
* Provides effective communication which includes verbal and good listening, writing, and presentation skills to a variety of stakeholders from executives to staff.
* Demonstrated ability to work in a professional, multi-disciplinary, matrix reporting team as a group leader, facilitator, or participant
* Demonstrates a track record of success.
* Demonstrates effective problem solving skills which includes understanding issues, able to simply and process complex issues, understanding the difference between critical details and unimportant facts.
EDUCATION
* Bachelor's degree required, Graduate degree preferred.
* Min of five years in a healthcare related role with experience directly related to the duties and responsibilities specified.
* Previous experience of supply chain, value analysis, purchased services and/or sourcing that includes strong medical capital equipment knowledge and experience required. Successful project management experience.
* Advance computer skills with MS Word, PowerPoint, and Excel. Software skills with data warehouse and/or Micro Strategies highly preferred.
In todays challenging business environment of cost pressures, supply disruptions, and workforce shortages, it is crucial for providers to efficiently manage expenses and enhance performance. HealthTrust, in collaboration with 1,800 hospitals and health systems, offers a specialized group purchasing organization (GPO) membership model designed to deliver immediate and sustainable cost savings. Their team of experts provides tailored value acceleration engagements to address specific needs, delivering unparalleled benefits. With nationwide purchasing power and a focus on overall spending management, HealthTrust offers unmatched pricing advantages on supplies, along with industry-leading benchmarks and best practices. The dedicated team is committed to guiding and implementing performance enhancements in cost, quality, and outcomes.
HCA Healthcare has been recognized as one of the World's Most Ethical Companies by the Ethisphere Institute more than ten times. In recent years. HCA Healthcare spent an estimated 3.7 billion in costs for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
"Bricks and mortar do not make a hospital. People do."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Senior Manager Capital Equipment WFH opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today!
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
$75k-94k yearly est. 1d ago
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VP, Medical Economics
Molina Healthcare Inc. 4.4
Columbus, OH jobs
Provides executive level strategy and leadership for team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance and outcomes. Collaborates with health plans to develop scoreable action item (SAI) tracking tools and identify opportunities to improve performance and data management, and support, guide and influence decision-making related to clinical programs, initiatives and strategy.
Essential Job Duties
* Regularly unpacks detailed medical cost information to identify significant trends development and underlying causes of those trends.
* Supports executive strategy development, vision and direction for the enterprise medical economics function including SAI analytics, governance and trend mitigation. Demonstrates accountability for performance and financial results, and keeps executive leadership apprised.
* Recruits, hires, onboards, mentors, develops, and manages a team of medical economics team of professionals.
* Collaborates with senior level clinicians and leaders from functional areas such as finance, health care services and provider contracting to translate analytic observations into meaningful clinical/operational actions and management of clinical services to support, guide and influence decision making related to clinical programs, initiatives and strategy.
* Leveraging targeted analytics, works with business leaders to develop programs to support affordable, high quality health care delivery.
* Identifies gaps in critical information and works with business leaders to develop solutions to capture or supplement information required.
* Informs and supports regular forecasting activities of the enterprise.
* Propagates best medical economics/analysis/SAI development practices across the enterprise.
* Leads enterprise information management (EIM) team to build out data analytic tools and capabilities.
* Develops standards with regard to routine health care economics analyses, including types of analyses performed, frequency by health plan or line of business, etc.
Required Qualifications
* At least 12 years of health care analytics and/or medical economics experience, including 3 years of experience at an executive level, or equivalent combination of relevant education and experience.
* At least 7 years management/leadership experience.
* Bachelor's degree in statistics, mathematics, economics, computer science, health care management or related field.
* Extensive experience in a leadership position in health care economics, preferably with complex organizations.
* Ability to effectively communicate and persuade technical and non-technical stakeholders, and engage with various levels within the organization
* Demonstrated ability to work with sophisticated analytic tools and datasets.
* Demonstrated ability to convert observations into actions/interventions to improve financial performance.
* Advanced understanding of Medicaid and Medicare programs or other health care plans.
* Advanced analytical work experience within the health care industry (i.e., hospital, network, ancillary, medical facility, health care vendor, commercial health insurance, large physician practice, managed care organization, etc.)
* Advanced proficiency with retrieving specified information from data sources.
* Advanced experience with building dashboards in Excel, Power BI, and/or Tableau and data management.
* Advanced understanding health care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.)
* Advanced understanding on health care financial terms (e.g., PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form).
* Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms.
* Advanced understanding of value-based risk arrangements
* Advanced experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics in health care.
* Advanced problem-solving skills.
* Strong critical-thinking and attention to detail.
* Excellent verbal and written communication skills.
* Proficient in Microsoft Office suite products, advanced skills in Excel (VLOOKUPs and pivot tables)/applicable software program(s) proficiency.
Preferred Qualifications
* Experience in complex managed care.
* Associate of the Society of Actuaries (ASA) or Fellow of the Society of Actuaries (FSA).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare 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 skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
$186.2k-363.1k yearly 60d+ ago
VP, Medical Economics
Molina Healthcare 4.4
Columbus, OH jobs
Provides executive level strategy and leadership for team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance and outcomes. Collaborates with health plans to develop scoreable action item (SAI) tracking tools and identify opportunities to improve performance and data management, and support, guide and influence decision-making related to clinical programs, initiatives and strategy.
**Essential Job Duties**
- Regularly unpacks detailed medical cost information to identify significant trends development and underlying causes of those trends.
- Supports executive strategy development, vision and direction for the enterprise medical economics function including SAI analytics, governance and trend mitigation. Demonstrates accountability for performance and financial results, and keeps executive leadership apprised.
- Recruits, hires, onboards, mentors, develops, and manages a team of medical economics team of professionals.
- Collaborates with senior level clinicians and leaders from functional areas such as finance, health care services and provider contracting to translate analytic observations into meaningful clinical/operational actions and management of clinical services to support, guide and influence decision making related to clinical programs, initiatives and strategy.
- Leveraging targeted analytics, works with business leaders to develop programs to support affordable, high quality health care delivery.
- Identifies gaps in critical information and works with business leaders to develop solutions to capture or supplement information required.
- Informs and supports regular forecasting activities of the enterprise.
- Propagates best medical economics/analysis/SAI development practices across the enterprise.
- Leads enterprise information management (EIM) team to build out data analytic tools and capabilities.
- Develops standards with regard to routine health care economics analyses, including types of analyses performed, frequency by health plan or line of business, etc.
**Required Qualifications**
- At least 12 years of health care analytics and/or medical economics experience, including 3 years of experience at an executive level, or equivalent combination of relevant education and experience.
- At least 7 years management/leadership experience.
- Bachelor's degree in statistics, mathematics, economics, computer science, health care management or related field.
- Extensive experience in a leadership position in health care economics, preferably with complex organizations.
- Ability to effectively communicate and persuade technical and non-technical stakeholders, and engage with various levels within the organization
- Demonstrated ability to work with sophisticated analytic tools and datasets.
- Demonstrated ability to convert observations into actions/interventions to improve financial performance.
- Advanced understanding of Medicaid and Medicare programs or other health care plans.
- Advanced analytical work experience within the health care industry (i.e., hospital, network, ancillary, medical facility, health care vendor, commercial health insurance, large physician practice, managed care organization, etc.)
- Advanced proficiency with retrieving specified information from data sources.
- Advanced experience with building dashboards in Excel, Power BI, and/or Tableau and data management.
- Advanced understanding health care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.)
- Advanced understanding on health care financial terms (e.g., PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form).
- Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms.
- Advanced understanding of value-based risk arrangements
- Advanced experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics in health care.
- Advanced problem-solving skills.
- Strong critical-thinking and attention to detail.
- Excellent verbal and written communication skills.
- Proficient in Microsoft Office suite products, advanced skills in Excel (VLOOKUPs and pivot tables)/applicable software program(s) proficiency.
**Preferred Qualifications**
-Experience in complex managed care.
- Associate of the Society of Actuaries (ASA) or Fellow of the Society of Actuaries (FSA).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare 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 skill level.
$186.2k-363.1k yearly 60d+ ago
VP, Medical Economics
Molina Healthcare Inc. 4.4
Cleveland, OH jobs
Provides executive level strategy and leadership for team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance and outcomes. Collaborates with health plans to develop scoreable action item (SAI) tracking tools and identify opportunities to improve performance and data management, and support, guide and influence decision-making related to clinical programs, initiatives and strategy.
Essential Job Duties
* Regularly unpacks detailed medical cost information to identify significant trends development and underlying causes of those trends.
* Supports executive strategy development, vision and direction for the enterprise medical economics function including SAI analytics, governance and trend mitigation. Demonstrates accountability for performance and financial results, and keeps executive leadership apprised.
* Recruits, hires, onboards, mentors, develops, and manages a team of medical economics team of professionals.
* Collaborates with senior level clinicians and leaders from functional areas such as finance, health care services and provider contracting to translate analytic observations into meaningful clinical/operational actions and management of clinical services to support, guide and influence decision making related to clinical programs, initiatives and strategy.
* Leveraging targeted analytics, works with business leaders to develop programs to support affordable, high quality health care delivery.
* Identifies gaps in critical information and works with business leaders to develop solutions to capture or supplement information required.
* Informs and supports regular forecasting activities of the enterprise.
* Propagates best medical economics/analysis/SAI development practices across the enterprise.
* Leads enterprise information management (EIM) team to build out data analytic tools and capabilities.
* Develops standards with regard to routine health care economics analyses, including types of analyses performed, frequency by health plan or line of business, etc.
Required Qualifications
* At least 12 years of health care analytics and/or medical economics experience, including 3 years of experience at an executive level, or equivalent combination of relevant education and experience.
* At least 7 years management/leadership experience.
* Bachelor's degree in statistics, mathematics, economics, computer science, health care management or related field.
* Extensive experience in a leadership position in health care economics, preferably with complex organizations.
* Ability to effectively communicate and persuade technical and non-technical stakeholders, and engage with various levels within the organization
* Demonstrated ability to work with sophisticated analytic tools and datasets.
* Demonstrated ability to convert observations into actions/interventions to improve financial performance.
* Advanced understanding of Medicaid and Medicare programs or other health care plans.
* Advanced analytical work experience within the health care industry (i.e., hospital, network, ancillary, medical facility, health care vendor, commercial health insurance, large physician practice, managed care organization, etc.)
* Advanced proficiency with retrieving specified information from data sources.
* Advanced experience with building dashboards in Excel, Power BI, and/or Tableau and data management.
* Advanced understanding health care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.)
* Advanced understanding on health care financial terms (e.g., PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form).
* Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms.
* Advanced understanding of value-based risk arrangements
* Advanced experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics in health care.
* Advanced problem-solving skills.
* Strong critical-thinking and attention to detail.
* Excellent verbal and written communication skills.
* Proficient in Microsoft Office suite products, advanced skills in Excel (VLOOKUPs and pivot tables)/applicable software program(s) proficiency.
Preferred Qualifications
* Experience in complex managed care.
* Associate of the Society of Actuaries (ASA) or Fellow of the Society of Actuaries (FSA).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare 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 skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
$186.2k-363.1k yearly 60d+ ago
VP, Medical Economics
Molina Healthcare 4.4
Cleveland, OH jobs
Provides executive level strategy and leadership for team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance and outcomes. Collaborates with health plans to develop scoreable action item (SAI) tracking tools and identify opportunities to improve performance and data management, and support, guide and influence decision-making related to clinical programs, initiatives and strategy.
**Essential Job Duties**
- Regularly unpacks detailed medical cost information to identify significant trends development and underlying causes of those trends.
- Supports executive strategy development, vision and direction for the enterprise medical economics function including SAI analytics, governance and trend mitigation. Demonstrates accountability for performance and financial results, and keeps executive leadership apprised.
- Recruits, hires, onboards, mentors, develops, and manages a team of medical economics team of professionals.
- Collaborates with senior level clinicians and leaders from functional areas such as finance, health care services and provider contracting to translate analytic observations into meaningful clinical/operational actions and management of clinical services to support, guide and influence decision making related to clinical programs, initiatives and strategy.
- Leveraging targeted analytics, works with business leaders to develop programs to support affordable, high quality health care delivery.
- Identifies gaps in critical information and works with business leaders to develop solutions to capture or supplement information required.
- Informs and supports regular forecasting activities of the enterprise.
- Propagates best medical economics/analysis/SAI development practices across the enterprise.
- Leads enterprise information management (EIM) team to build out data analytic tools and capabilities.
- Develops standards with regard to routine health care economics analyses, including types of analyses performed, frequency by health plan or line of business, etc.
**Required Qualifications**
- At least 12 years of health care analytics and/or medical economics experience, including 3 years of experience at an executive level, or equivalent combination of relevant education and experience.
- At least 7 years management/leadership experience.
- Bachelor's degree in statistics, mathematics, economics, computer science, health care management or related field.
- Extensive experience in a leadership position in health care economics, preferably with complex organizations.
- Ability to effectively communicate and persuade technical and non-technical stakeholders, and engage with various levels within the organization
- Demonstrated ability to work with sophisticated analytic tools and datasets.
- Demonstrated ability to convert observations into actions/interventions to improve financial performance.
- Advanced understanding of Medicaid and Medicare programs or other health care plans.
- Advanced analytical work experience within the health care industry (i.e., hospital, network, ancillary, medical facility, health care vendor, commercial health insurance, large physician practice, managed care organization, etc.)
- Advanced proficiency with retrieving specified information from data sources.
- Advanced experience with building dashboards in Excel, Power BI, and/or Tableau and data management.
- Advanced understanding health care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.)
- Advanced understanding on health care financial terms (e.g., PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form).
- Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms.
- Advanced understanding of value-based risk arrangements
- Advanced experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics in health care.
- Advanced problem-solving skills.
- Strong critical-thinking and attention to detail.
- Excellent verbal and written communication skills.
- Proficient in Microsoft Office suite products, advanced skills in Excel (VLOOKUPs and pivot tables)/applicable software program(s) proficiency.
**Preferred Qualifications**
-Experience in complex managed care.
- Associate of the Society of Actuaries (ASA) or Fellow of the Society of Actuaries (FSA).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare 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 skill level.
$186.2k-363.1k yearly 60d+ ago
VP, Medical Economics
Molina Healthcare Inc. 4.4
Dayton, OH jobs
Provides executive level strategy and leadership for team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance and outcomes. Collaborates with health plans to develop scoreable action item (SAI) tracking tools and identify opportunities to improve performance and data management, and support, guide and influence decision-making related to clinical programs, initiatives and strategy.
Essential Job Duties
* Regularly unpacks detailed medical cost information to identify significant trends development and underlying causes of those trends.
* Supports executive strategy development, vision and direction for the enterprise medical economics function including SAI analytics, governance and trend mitigation. Demonstrates accountability for performance and financial results, and keeps executive leadership apprised.
* Recruits, hires, onboards, mentors, develops, and manages a team of medical economics team of professionals.
* Collaborates with senior level clinicians and leaders from functional areas such as finance, health care services and provider contracting to translate analytic observations into meaningful clinical/operational actions and management of clinical services to support, guide and influence decision making related to clinical programs, initiatives and strategy.
* Leveraging targeted analytics, works with business leaders to develop programs to support affordable, high quality health care delivery.
* Identifies gaps in critical information and works with business leaders to develop solutions to capture or supplement information required.
* Informs and supports regular forecasting activities of the enterprise.
* Propagates best medical economics/analysis/SAI development practices across the enterprise.
* Leads enterprise information management (EIM) team to build out data analytic tools and capabilities.
* Develops standards with regard to routine health care economics analyses, including types of analyses performed, frequency by health plan or line of business, etc.
Required Qualifications
* At least 12 years of health care analytics and/or medical economics experience, including 3 years of experience at an executive level, or equivalent combination of relevant education and experience.
* At least 7 years management/leadership experience.
* Bachelor's degree in statistics, mathematics, economics, computer science, health care management or related field.
* Extensive experience in a leadership position in health care economics, preferably with complex organizations.
* Ability to effectively communicate and persuade technical and non-technical stakeholders, and engage with various levels within the organization
* Demonstrated ability to work with sophisticated analytic tools and datasets.
* Demonstrated ability to convert observations into actions/interventions to improve financial performance.
* Advanced understanding of Medicaid and Medicare programs or other health care plans.
* Advanced analytical work experience within the health care industry (i.e., hospital, network, ancillary, medical facility, health care vendor, commercial health insurance, large physician practice, managed care organization, etc.)
* Advanced proficiency with retrieving specified information from data sources.
* Advanced experience with building dashboards in Excel, Power BI, and/or Tableau and data management.
* Advanced understanding health care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.)
* Advanced understanding on health care financial terms (e.g., PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form).
* Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms.
* Advanced understanding of value-based risk arrangements
* Advanced experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics in health care.
* Advanced problem-solving skills.
* Strong critical-thinking and attention to detail.
* Excellent verbal and written communication skills.
* Proficient in Microsoft Office suite products, advanced skills in Excel (VLOOKUPs and pivot tables)/applicable software program(s) proficiency.
Preferred Qualifications
* Experience in complex managed care.
* Associate of the Society of Actuaries (ASA) or Fellow of the Society of Actuaries (FSA).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare 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 skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
$186.2k-363.1k yearly 60d+ ago
VP, Medical Economics
Molina Healthcare 4.4
Dayton, OH jobs
Provides executive level strategy and leadership for team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance and outcomes. Collaborates with health plans to develop scoreable action item (SAI) tracking tools and identify opportunities to improve performance and data management, and support, guide and influence decision-making related to clinical programs, initiatives and strategy.
**Essential Job Duties**
- Regularly unpacks detailed medical cost information to identify significant trends development and underlying causes of those trends.
- Supports executive strategy development, vision and direction for the enterprise medical economics function including SAI analytics, governance and trend mitigation. Demonstrates accountability for performance and financial results, and keeps executive leadership apprised.
- Recruits, hires, onboards, mentors, develops, and manages a team of medical economics team of professionals.
- Collaborates with senior level clinicians and leaders from functional areas such as finance, health care services and provider contracting to translate analytic observations into meaningful clinical/operational actions and management of clinical services to support, guide and influence decision making related to clinical programs, initiatives and strategy.
- Leveraging targeted analytics, works with business leaders to develop programs to support affordable, high quality health care delivery.
- Identifies gaps in critical information and works with business leaders to develop solutions to capture or supplement information required.
- Informs and supports regular forecasting activities of the enterprise.
- Propagates best medical economics/analysis/SAI development practices across the enterprise.
- Leads enterprise information management (EIM) team to build out data analytic tools and capabilities.
- Develops standards with regard to routine health care economics analyses, including types of analyses performed, frequency by health plan or line of business, etc.
**Required Qualifications**
- At least 12 years of health care analytics and/or medical economics experience, including 3 years of experience at an executive level, or equivalent combination of relevant education and experience.
- At least 7 years management/leadership experience.
- Bachelor's degree in statistics, mathematics, economics, computer science, health care management or related field.
- Extensive experience in a leadership position in health care economics, preferably with complex organizations.
- Ability to effectively communicate and persuade technical and non-technical stakeholders, and engage with various levels within the organization
- Demonstrated ability to work with sophisticated analytic tools and datasets.
- Demonstrated ability to convert observations into actions/interventions to improve financial performance.
- Advanced understanding of Medicaid and Medicare programs or other health care plans.
- Advanced analytical work experience within the health care industry (i.e., hospital, network, ancillary, medical facility, health care vendor, commercial health insurance, large physician practice, managed care organization, etc.)
- Advanced proficiency with retrieving specified information from data sources.
- Advanced experience with building dashboards in Excel, Power BI, and/or Tableau and data management.
- Advanced understanding health care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.)
- Advanced understanding on health care financial terms (e.g., PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form).
- Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms.
- Advanced understanding of value-based risk arrangements
- Advanced experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics in health care.
- Advanced problem-solving skills.
- Strong critical-thinking and attention to detail.
- Excellent verbal and written communication skills.
- Proficient in Microsoft Office suite products, advanced skills in Excel (VLOOKUPs and pivot tables)/applicable software program(s) proficiency.
**Preferred Qualifications**
-Experience in complex managed care.
- Associate of the Society of Actuaries (ASA) or Fellow of the Society of Actuaries (FSA).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare 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 skill level.
$186.2k-363.1k yearly 60d+ ago
VP, Medical Economics
Molina Healthcare Inc. 4.4
Akron, OH jobs
Provides executive level strategy and leadership for team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance and outcomes. Collaborates with health plans to develop scoreable action item (SAI) tracking tools and identify opportunities to improve performance and data management, and support, guide and influence decision-making related to clinical programs, initiatives and strategy.
Essential Job Duties
* Regularly unpacks detailed medical cost information to identify significant trends development and underlying causes of those trends.
* Supports executive strategy development, vision and direction for the enterprise medical economics function including SAI analytics, governance and trend mitigation. Demonstrates accountability for performance and financial results, and keeps executive leadership apprised.
* Recruits, hires, onboards, mentors, develops, and manages a team of medical economics team of professionals.
* Collaborates with senior level clinicians and leaders from functional areas such as finance, health care services and provider contracting to translate analytic observations into meaningful clinical/operational actions and management of clinical services to support, guide and influence decision making related to clinical programs, initiatives and strategy.
* Leveraging targeted analytics, works with business leaders to develop programs to support affordable, high quality health care delivery.
* Identifies gaps in critical information and works with business leaders to develop solutions to capture or supplement information required.
* Informs and supports regular forecasting activities of the enterprise.
* Propagates best medical economics/analysis/SAI development practices across the enterprise.
* Leads enterprise information management (EIM) team to build out data analytic tools and capabilities.
* Develops standards with regard to routine health care economics analyses, including types of analyses performed, frequency by health plan or line of business, etc.
Required Qualifications
* At least 12 years of health care analytics and/or medical economics experience, including 3 years of experience at an executive level, or equivalent combination of relevant education and experience.
* At least 7 years management/leadership experience.
* Bachelor's degree in statistics, mathematics, economics, computer science, health care management or related field.
* Extensive experience in a leadership position in health care economics, preferably with complex organizations.
* Ability to effectively communicate and persuade technical and non-technical stakeholders, and engage with various levels within the organization
* Demonstrated ability to work with sophisticated analytic tools and datasets.
* Demonstrated ability to convert observations into actions/interventions to improve financial performance.
* Advanced understanding of Medicaid and Medicare programs or other health care plans.
* Advanced analytical work experience within the health care industry (i.e., hospital, network, ancillary, medical facility, health care vendor, commercial health insurance, large physician practice, managed care organization, etc.)
* Advanced proficiency with retrieving specified information from data sources.
* Advanced experience with building dashboards in Excel, Power BI, and/or Tableau and data management.
* Advanced understanding health care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.)
* Advanced understanding on health care financial terms (e.g., PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form).
* Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms.
* Advanced understanding of value-based risk arrangements
* Advanced experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics in health care.
* Advanced problem-solving skills.
* Strong critical-thinking and attention to detail.
* Excellent verbal and written communication skills.
* Proficient in Microsoft Office suite products, advanced skills in Excel (VLOOKUPs and pivot tables)/applicable software program(s) proficiency.
Preferred Qualifications
* Experience in complex managed care.
* Associate of the Society of Actuaries (ASA) or Fellow of the Society of Actuaries (FSA).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare 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 skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
$186.2k-363.1k yearly 60d+ ago
VP, Medical Economics
Molina Healthcare 4.4
Cincinnati, OH jobs
Provides executive level strategy and leadership for team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance and outcomes. Collaborates with health plans to develop scoreable action item (SAI) tracking tools and identify opportunities to improve performance and data management, and support, guide and influence decision-making related to clinical programs, initiatives and strategy.
**Essential Job Duties**
- Regularly unpacks detailed medical cost information to identify significant trends development and underlying causes of those trends.
- Supports executive strategy development, vision and direction for the enterprise medical economics function including SAI analytics, governance and trend mitigation. Demonstrates accountability for performance and financial results, and keeps executive leadership apprised.
- Recruits, hires, onboards, mentors, develops, and manages a team of medical economics team of professionals.
- Collaborates with senior level clinicians and leaders from functional areas such as finance, health care services and provider contracting to translate analytic observations into meaningful clinical/operational actions and management of clinical services to support, guide and influence decision making related to clinical programs, initiatives and strategy.
- Leveraging targeted analytics, works with business leaders to develop programs to support affordable, high quality health care delivery.
- Identifies gaps in critical information and works with business leaders to develop solutions to capture or supplement information required.
- Informs and supports regular forecasting activities of the enterprise.
- Propagates best medical economics/analysis/SAI development practices across the enterprise.
- Leads enterprise information management (EIM) team to build out data analytic tools and capabilities.
- Develops standards with regard to routine health care economics analyses, including types of analyses performed, frequency by health plan or line of business, etc.
**Required Qualifications**
- At least 12 years of health care analytics and/or medical economics experience, including 3 years of experience at an executive level, or equivalent combination of relevant education and experience.
- At least 7 years management/leadership experience.
- Bachelor's degree in statistics, mathematics, economics, computer science, health care management or related field.
- Extensive experience in a leadership position in health care economics, preferably with complex organizations.
- Ability to effectively communicate and persuade technical and non-technical stakeholders, and engage with various levels within the organization
- Demonstrated ability to work with sophisticated analytic tools and datasets.
- Demonstrated ability to convert observations into actions/interventions to improve financial performance.
- Advanced understanding of Medicaid and Medicare programs or other health care plans.
- Advanced analytical work experience within the health care industry (i.e., hospital, network, ancillary, medical facility, health care vendor, commercial health insurance, large physician practice, managed care organization, etc.)
- Advanced proficiency with retrieving specified information from data sources.
- Advanced experience with building dashboards in Excel, Power BI, and/or Tableau and data management.
- Advanced understanding health care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.)
- Advanced understanding on health care financial terms (e.g., PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form).
- Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms.
- Advanced understanding of value-based risk arrangements
- Advanced experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics in health care.
- Advanced problem-solving skills.
- Strong critical-thinking and attention to detail.
- Excellent verbal and written communication skills.
- Proficient in Microsoft Office suite products, advanced skills in Excel (VLOOKUPs and pivot tables)/applicable software program(s) proficiency.
**Preferred Qualifications**
-Experience in complex managed care.
- Associate of the Society of Actuaries (ASA) or Fellow of the Society of Actuaries (FSA).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare 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 skill level.
$186.2k-363.1k yearly 60d+ ago
VP, Medical Economics
Molina Healthcare 4.4
Akron, OH jobs
Provides executive level strategy and leadership for team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance and outcomes. Collaborates with health plans to develop scoreable action item (SAI) tracking tools and identify opportunities to improve performance and data management, and support, guide and influence decision-making related to clinical programs, initiatives and strategy.
**Essential Job Duties**
- Regularly unpacks detailed medical cost information to identify significant trends development and underlying causes of those trends.
- Supports executive strategy development, vision and direction for the enterprise medical economics function including SAI analytics, governance and trend mitigation. Demonstrates accountability for performance and financial results, and keeps executive leadership apprised.
- Recruits, hires, onboards, mentors, develops, and manages a team of medical economics team of professionals.
- Collaborates with senior level clinicians and leaders from functional areas such as finance, health care services and provider contracting to translate analytic observations into meaningful clinical/operational actions and management of clinical services to support, guide and influence decision making related to clinical programs, initiatives and strategy.
- Leveraging targeted analytics, works with business leaders to develop programs to support affordable, high quality health care delivery.
- Identifies gaps in critical information and works with business leaders to develop solutions to capture or supplement information required.
- Informs and supports regular forecasting activities of the enterprise.
- Propagates best medical economics/analysis/SAI development practices across the enterprise.
- Leads enterprise information management (EIM) team to build out data analytic tools and capabilities.
- Develops standards with regard to routine health care economics analyses, including types of analyses performed, frequency by health plan or line of business, etc.
**Required Qualifications**
- At least 12 years of health care analytics and/or medical economics experience, including 3 years of experience at an executive level, or equivalent combination of relevant education and experience.
- At least 7 years management/leadership experience.
- Bachelor's degree in statistics, mathematics, economics, computer science, health care management or related field.
- Extensive experience in a leadership position in health care economics, preferably with complex organizations.
- Ability to effectively communicate and persuade technical and non-technical stakeholders, and engage with various levels within the organization
- Demonstrated ability to work with sophisticated analytic tools and datasets.
- Demonstrated ability to convert observations into actions/interventions to improve financial performance.
- Advanced understanding of Medicaid and Medicare programs or other health care plans.
- Advanced analytical work experience within the health care industry (i.e., hospital, network, ancillary, medical facility, health care vendor, commercial health insurance, large physician practice, managed care organization, etc.)
- Advanced proficiency with retrieving specified information from data sources.
- Advanced experience with building dashboards in Excel, Power BI, and/or Tableau and data management.
- Advanced understanding health care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.)
- Advanced understanding on health care financial terms (e.g., PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form).
- Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms.
- Advanced understanding of value-based risk arrangements
- Advanced experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics in health care.
- Advanced problem-solving skills.
- Strong critical-thinking and attention to detail.
- Excellent verbal and written communication skills.
- Proficient in Microsoft Office suite products, advanced skills in Excel (VLOOKUPs and pivot tables)/applicable software program(s) proficiency.
**Preferred Qualifications**
-Experience in complex managed care.
- Associate of the Society of Actuaries (ASA) or Fellow of the Society of Actuaries (FSA).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare 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 skill level.
$186.2k-363.1k yearly 60d+ ago
VP De Novo Sourcing, USPI - Carolinas & Tennessee
Tenet Healthcare 4.5
Remote
COMPANY BACKGROUND:
Tenet Healthcare Corporation (NYSE: THC) is a diversified healthcare services company headquartered in Dallas. Our care delivery network includes United Surgical Partners International, the largest ambulatory platform in the country, which operates ambulatory surgery centers and surgical hospitals. We also operate a national portfolio of acute care and specialty hospitals, other outpatient facilities, a network of leading employed physicians and a global business center in Manila, Philippines. Our Conifer Health Solutions subsidiary provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers, and other clients. Across the Tenet enterprise, we are united by our mission to deliver quality, compassionate care in the communities we serve. For more information, please visit ********************** *************
JOB DESCRIPTION:
A De Novo VicePresident (“DNVP”) will lead efforts to grow USPI's pipeline of newly constructed outpatient surgical facilities (de novos). This position is responsible for leading sourcing efforts and USPI enterprise approach to building new ASC partnerships with physicians in the Carolinas & Tennessee. The role will include extensive engagement and relationship development with physicians as well as identifying and driving viable opportunities to successful syndication.
The DNVP will be responsible for company-wide capital development projects, with frequent travel required in order to effectively lead and execute on team initiatives. Creativity, innovation, self-reliance, organization and relationship-driven thinking are keys to success in this position. This role is responsible for educating providers on the benefits of a surgical center investment and appropriately explaining the USPI value proposition and differentiators that make a partnership with USPI successful. All provider engagement is to be done in accordance with the Company's Standards of Conduct and policies and procedures, particularly those involving referral source arrangements
REQUIRED SKILLS:
Bachelor's Degree Required.
At least 7 years of experience in a field related to health system physician relations, pharmaceuticals, or medical devices
Extensive experience working with physicians and within healthcare organizations whose recognition and reputation for excellence and quality place them at or near the top of the healthcare delivery system.
Represent the organization at all times. Be supportive of other managers and set an example of high personal and professional conduct and integrity for employees and others.
Ability to identify strategic priorities and drive them to completion.
Embrace collaborative leadership style; ability to seek input and counsel from a wide constituency, without losing decisiveness or the ability to take action and inspire others to action, as appropriate.
OTHER REQUIREMENTS:
Exhibited success in a business development / sales role
Demonstrate excellent organizational, interpersonal, facilitation, and communication skills
Capacity to work independently with minimal supervision
Ability to travel up to 50% of time. Selected candidate will be required to pass a Motor Vehicle Record check.
#LI-CD1
RESPONSIBILITIES AND EXPECTATIONS
Lead the sourcing efforts for de novo projects by enhancing company sourcing strategy around people, process, and pipeline approach.
Assess market dynamics, physician practice trends, and competition to inform and prioritize strategies around new facility demand and growth.
Research physicians to understand the decision making behind facility selection and other ASC and / or hospital relationships the providers may have. This information should inform provider engagement.
Maintain a robust pipeline of active external physician recruits, effectively communicate USPI centers' value proposition, and facilitate new physician starts at USPI centers
Foster, nurture, and maintain relationships with USPI's potential and existing physician partners to drive new opportunities for the company.
Maintain latest knowledge of the market hospital, ambulatory surgery, and provider landscape in the defined market service area.
Assist in the formation of JV partnerships and the syndication of ownership interests to physicians, including financial projections, preparation of syndication documents, etc.
Identify and help guide process improvement opportunities across de novo sourcing and execution.
Partner with USPI business leaders before, during and after projects are complete to ensure they make strategic sense, fit with forward-looking business plans, and are integrated smoothly and fully optimized.
$136k-195k yearly est. Auto-Apply 22d ago
VP, Medical Economics
Molina Healthcare Inc. 4.4
Ohio jobs
Provides executive level strategy and leadership for team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance and outcomes. Collaborates with health plans to develop scoreable action item (SAI) tracking tools and identify opportunities to improve performance and data management, and support, guide and influence decision-making related to clinical programs, initiatives and strategy.
Essential Job Duties
* Regularly unpacks detailed medical cost information to identify significant trends development and underlying causes of those trends.
* Supports executive strategy development, vision and direction for the enterprise medical economics function including SAI analytics, governance and trend mitigation. Demonstrates accountability for performance and financial results, and keeps executive leadership apprised.
* Recruits, hires, onboards, mentors, develops, and manages a team of medical economics team of professionals.
* Collaborates with senior level clinicians and leaders from functional areas such as finance, health care services and provider contracting to translate analytic observations into meaningful clinical/operational actions and management of clinical services to support, guide and influence decision making related to clinical programs, initiatives and strategy.
* Leveraging targeted analytics, works with business leaders to develop programs to support affordable, high quality health care delivery.
* Identifies gaps in critical information and works with business leaders to develop solutions to capture or supplement information required.
* Informs and supports regular forecasting activities of the enterprise.
* Propagates best medical economics/analysis/SAI development practices across the enterprise.
* Leads enterprise information management (EIM) team to build out data analytic tools and capabilities.
* Develops standards with regard to routine health care economics analyses, including types of analyses performed, frequency by health plan or line of business, etc.
Required Qualifications
* At least 12 years of health care analytics and/or medical economics experience, including 3 years of experience at an executive level, or equivalent combination of relevant education and experience.
* At least 7 years management/leadership experience.
* Bachelor's degree in statistics, mathematics, economics, computer science, health care management or related field.
* Extensive experience in a leadership position in health care economics, preferably with complex organizations.
* Ability to effectively communicate and persuade technical and non-technical stakeholders, and engage with various levels within the organization
* Demonstrated ability to work with sophisticated analytic tools and datasets.
* Demonstrated ability to convert observations into actions/interventions to improve financial performance.
* Advanced understanding of Medicaid and Medicare programs or other health care plans.
* Advanced analytical work experience within the health care industry (i.e., hospital, network, ancillary, medical facility, health care vendor, commercial health insurance, large physician practice, managed care organization, etc.)
* Advanced proficiency with retrieving specified information from data sources.
* Advanced experience with building dashboards in Excel, Power BI, and/or Tableau and data management.
* Advanced understanding health care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.)
* Advanced understanding on health care financial terms (e.g., PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form).
* Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms.
* Advanced understanding of value-based risk arrangements
* Advanced experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics in health care.
* Advanced problem-solving skills.
* Strong critical-thinking and attention to detail.
* Excellent verbal and written communication skills.
* Proficient in Microsoft Office suite products, advanced skills in Excel (VLOOKUPs and pivot tables)/applicable software program(s) proficiency.
Preferred Qualifications
* Experience in complex managed care.
* Associate of the Society of Actuaries (ASA) or Fellow of the Society of Actuaries (FSA).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare 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 skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
$186.2k-363.1k yearly 60d+ ago
VP, Medical Economics
Molina Healthcare 4.4
Ohio jobs
Provides executive level strategy and leadership for team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance and outcomes. Collaborates with health plans to develop scoreable action item (SAI) tracking tools and identify opportunities to improve performance and data management, and support, guide and influence decision-making related to clinical programs, initiatives and strategy.
**Essential Job Duties**
- Regularly unpacks detailed medical cost information to identify significant trends development and underlying causes of those trends.
- Supports executive strategy development, vision and direction for the enterprise medical economics function including SAI analytics, governance and trend mitigation. Demonstrates accountability for performance and financial results, and keeps executive leadership apprised.
- Recruits, hires, onboards, mentors, develops, and manages a team of medical economics team of professionals.
- Collaborates with senior level clinicians and leaders from functional areas such as finance, health care services and provider contracting to translate analytic observations into meaningful clinical/operational actions and management of clinical services to support, guide and influence decision making related to clinical programs, initiatives and strategy.
- Leveraging targeted analytics, works with business leaders to develop programs to support affordable, high quality health care delivery.
- Identifies gaps in critical information and works with business leaders to develop solutions to capture or supplement information required.
- Informs and supports regular forecasting activities of the enterprise.
- Propagates best medical economics/analysis/SAI development practices across the enterprise.
- Leads enterprise information management (EIM) team to build out data analytic tools and capabilities.
- Develops standards with regard to routine health care economics analyses, including types of analyses performed, frequency by health plan or line of business, etc.
**Required Qualifications**
- At least 12 years of health care analytics and/or medical economics experience, including 3 years of experience at an executive level, or equivalent combination of relevant education and experience.
- At least 7 years management/leadership experience.
- Bachelor's degree in statistics, mathematics, economics, computer science, health care management or related field.
- Extensive experience in a leadership position in health care economics, preferably with complex organizations.
- Ability to effectively communicate and persuade technical and non-technical stakeholders, and engage with various levels within the organization
- Demonstrated ability to work with sophisticated analytic tools and datasets.
- Demonstrated ability to convert observations into actions/interventions to improve financial performance.
- Advanced understanding of Medicaid and Medicare programs or other health care plans.
- Advanced analytical work experience within the health care industry (i.e., hospital, network, ancillary, medical facility, health care vendor, commercial health insurance, large physician practice, managed care organization, etc.)
- Advanced proficiency with retrieving specified information from data sources.
- Advanced experience with building dashboards in Excel, Power BI, and/or Tableau and data management.
- Advanced understanding health care operations (utilization management, disease management, HEDIS quality measures, claims processing, etc.)
- Advanced understanding on health care financial terms (e.g., PMPM, revenue) and different standard code systems (ICD-10CM, CPT, HCPCS, NDC, etc.) utilized in medical coding/billing (UB04/1500 form).
- Advanced understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), Ambulatory Patient Groups (APG's), Ambulatory Payment Classifications (APC's), and other payment mechanisms.
- Advanced understanding of value-based risk arrangements
- Advanced experience in quantifying, measuring, and analyzing financial, operational, and/or utilization metrics in health care.
- Advanced problem-solving skills.
- Strong critical-thinking and attention to detail.
- Excellent verbal and written communication skills.
- Proficient in Microsoft Office suite products, advanced skills in Excel (VLOOKUPs and pivot tables)/applicable software program(s) proficiency.
**Preferred Qualifications**
-Experience in complex managed care.
- Associate of the Society of Actuaries (ASA) or Fellow of the Society of Actuaries (FSA).
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare 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 skill level.
$186.2k-363.1k yearly 60d+ ago
Strategy Advancement Director
Molina Healthcare Inc. 4.4
Columbus, OH jobs
The Strategy Advancement Director is responsible for advancing Molina's growth strategy and positioning the company for success in Medicaid, CHIP, DSNP, and Marketplace procurements. Reporting to the VicePresident, Business Development, this position plays a pivotal role in the pre-RFP and procurement phases, guiding and organizing the project, ensuring deliverables are met, conducting research, tracking Business Development and/or Health Plan steps and projects, owning the governance structure for every opportunity, pulling together all the supporting team activities and pieces and connecting the dots between winning strategy and the relationships and partnerships developed by the VP, Business Development.
This role requires a deep understanding of Medicaid programs, the regulatory environment, and the unique challenges of populations (i.e. TANF, ABD, DSNP, Foster Care, and DD/IDD). The Strategy Advancement Director works collaboratively across departments, including Product Development, Business Development, and Health Plans, to ensure that strategic initiatives align with state-specific priorities and are positioned for success in competitive procurements. The Director partners with the VP Market Development to provide thought leadership and subject matter expertise, identifying trends, providing insights, and continuously innovating to strengthen Molina's market position.
Job Duties
* Strategy Development & Innovation
* Collaborate on the development of state-specific strategies aligned with state priorities, procurement objectives, and evolving Medicaid needs. Translate state regulatory requirements into actionable go-to-market strategies that are innovative and differentiate Molina in competitive procurements
* Collaborate with Product Development, Health Plan leaders, Growth Leaders and cross-functional teams to support integration of innovative care models, operational efficiencies, and value-based care solutions tailored to the unique needs of market specific Medicaid populations, especially high-risk or vulnerable groups such as dual-eligible members, foster care, and ABD
* Conduct market research, analyze industry trends, and monitor competitor activities to identify innovation opportunities. Propose solutions that address Medicaid ecosystem pain points and enhance Molina's value proposition
* Use insights from market research and competitive analysis to stay informed on state Medicaid trends, regulatory changes, and market conditions, and to guide strategic adjustments and future market positioning
* Drive the development of win themes and strategy recommendations that align with state priorities, competitive dynamics, and the latest Medicaid trends, positioning Molina as a leader in Medicaid managed care
* Track regulatory compliance and address any operational concerns or state-specific issues identified during the pre-procurement phase. Escalate issues when necessary and work to resolve them proactively
* Market Development and Strategy Execution
* Collaborate on the development of pre-RFP strategy and market readiness, creating and tracking playbooks, plans, and deliverables for Molina's strategy two to three years before RFP release. Ensure alignment with organizational goals and state requirements by collaborating with Market VPs, AVPs, and stakeholders
* Identify and engage in thought leadership opportunities by representing Molina at state and national Medicaid conferences, industry forums, and other key events that enhance Molina's brand and expertise in Medicaid care delivery
* Stakeholder Engagement & Thought Leadership
* Support and track the development of relationships with state agencies, legislative leaders, regulatory bodies, and community organizations to enhance Molina's reputation and strengthen partnerships that could influence procurement outcomes
* Represent Molina in strategic discussions with external partners and internal leadership, ensuring clear communication of strategy, innovation, and value propositions
* Collaborate with internal stakeholders to influence thought leadership materials and content that showcase Molina's innovative approaches to Medicaid, particularly in high-needs areas like DSNP, ABD, and complex populations
* Proposal Support & Competitive Differentiation
* Serve as an expert on the pre-procurement process for the proposal team and closely collaborate with the Proposal Director to ensure consistency between market strategy, capture strategy and proposal content. Collaborate with the Proposal Director to ensure consistency between market strategy and RFP content
* Track and support the execution of win strategy and strategic recommendations being incorporated throughout the proposal, ensuring Molina's proposals are differentiated and align with state-specific priorities and the competitive landscape
* Actively participate in blue, pink, and red team reviews, providing strategic feedback to ensure proposal materials effectively communicate Molina's competitive advantages and compliance with RFP requirements
* Support orals preparation, working across matrix partners to refine materials and messaging for presentations to state agencies
* Operational Excellence & Cross-Functional Coordination
* Use tools (i.e. Salesforce) to document market intelligence, track engagement activities, and share insights across departments. Ensure that data-driven insights are leveraged in proposal content development and strategic planning
* Collaborate with the Growth Strategy, Competitive Intelligence and other stakeholders to leverage the competitive intelligence repository that informs decision-making and provides a strategic edge in Medicaid procurements
* Develop project plans and roadmaps to guide the timely execution of pre-RFP and procurement activities, ensuring effective collaboration and alignment across functional teams
* Facilitate cross-functional coordination for market entry, retention, and development strategies, ensuring that all teams are aligned and executing efficiently
* Supports the VP Business Development as a SME during the "warranty period" post award through implementation to the IMO and health plan leadership
* Mentorship & Team Development
* Mentor junior staff and interns within the Business Development teams, fostering skills in strategic thinking, market research, and pre-procurement planning
* Participate in business development activities on an ad-hoc basis, contributing to team knowledge and providing strategic insights to senior leadership
* 50% or more Travel required
Job Qualifications
REQUIRED QUALIFICATIONS:
* Bachelor's degree in business, Public Policy, Healthcare Administration or a related field or equivalent combination of education and experience
* 7 years in market strategy, business development, or healthcare consulting, specifically within Medicaid managed care or equivalent related field
* Proven experience in pre-RFP strategy development, with a strong understanding of Medicaid programs, including TANF, ABD, DSNP, and CHIP populations
* Demonstrated ability to drive innovative solutions in the Medicaid space, leveraging market research and industry trends to inform strategic decisions
* Experience with Salesforce or similar tools to track market insights, engagement activities, and manage data
* Strong experience in stakeholder engagement, particularly with state Medicaid agencies, regulatory bodies, and community-based organizations
* Advanced proficiency in Microsoft Office tools (Excel, PowerPoint, Word), including for strategy development, data analysis, and presentation creation
PREFERRED QUALIFICATIONS:
* Master's degree (MBA, MPH, MPA) in business, public policy, or healthcare administration
* 7+ years in business development and Medicaid procurements, particularly with complex populations (e.g., DD/IDD, Foster Care, Dual-Eligible Members)
* Experience with Salesforce or similar tools to track market insights, engagement activities, and manage data
* Conference management experience and participation in industry forums
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: $107,028 - $208,705 / ANNUAL
* Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
$107k-208.7k yearly 15d ago
Strategy Advancement Director
Molina Healthcare Inc. 4.4
Cleveland, OH jobs
The Strategy Advancement Director is responsible for advancing Molina's growth strategy and positioning the company for success in Medicaid, CHIP, DSNP, and Marketplace procurements. Reporting to the VicePresident, Business Development, this position plays a pivotal role in the pre-RFP and procurement phases, guiding and organizing the project, ensuring deliverables are met, conducting research, tracking Business Development and/or Health Plan steps and projects, owning the governance structure for every opportunity, pulling together all the supporting team activities and pieces and connecting the dots between winning strategy and the relationships and partnerships developed by the VP, Business Development.
This role requires a deep understanding of Medicaid programs, the regulatory environment, and the unique challenges of populations (i.e. TANF, ABD, DSNP, Foster Care, and DD/IDD). The Strategy Advancement Director works collaboratively across departments, including Product Development, Business Development, and Health Plans, to ensure that strategic initiatives align with state-specific priorities and are positioned for success in competitive procurements. The Director partners with the VP Market Development to provide thought leadership and subject matter expertise, identifying trends, providing insights, and continuously innovating to strengthen Molina's market position.
Job Duties
* Strategy Development & Innovation
* Collaborate on the development of state-specific strategies aligned with state priorities, procurement objectives, and evolving Medicaid needs. Translate state regulatory requirements into actionable go-to-market strategies that are innovative and differentiate Molina in competitive procurements
* Collaborate with Product Development, Health Plan leaders, Growth Leaders and cross-functional teams to support integration of innovative care models, operational efficiencies, and value-based care solutions tailored to the unique needs of market specific Medicaid populations, especially high-risk or vulnerable groups such as dual-eligible members, foster care, and ABD
* Conduct market research, analyze industry trends, and monitor competitor activities to identify innovation opportunities. Propose solutions that address Medicaid ecosystem pain points and enhance Molina's value proposition
* Use insights from market research and competitive analysis to stay informed on state Medicaid trends, regulatory changes, and market conditions, and to guide strategic adjustments and future market positioning
* Drive the development of win themes and strategy recommendations that align with state priorities, competitive dynamics, and the latest Medicaid trends, positioning Molina as a leader in Medicaid managed care
* Track regulatory compliance and address any operational concerns or state-specific issues identified during the pre-procurement phase. Escalate issues when necessary and work to resolve them proactively
* Market Development and Strategy Execution
* Collaborate on the development of pre-RFP strategy and market readiness, creating and tracking playbooks, plans, and deliverables for Molina's strategy two to three years before RFP release. Ensure alignment with organizational goals and state requirements by collaborating with Market VPs, AVPs, and stakeholders
* Identify and engage in thought leadership opportunities by representing Molina at state and national Medicaid conferences, industry forums, and other key events that enhance Molina's brand and expertise in Medicaid care delivery
* Stakeholder Engagement & Thought Leadership
* Support and track the development of relationships with state agencies, legislative leaders, regulatory bodies, and community organizations to enhance Molina's reputation and strengthen partnerships that could influence procurement outcomes
* Represent Molina in strategic discussions with external partners and internal leadership, ensuring clear communication of strategy, innovation, and value propositions
* Collaborate with internal stakeholders to influence thought leadership materials and content that showcase Molina's innovative approaches to Medicaid, particularly in high-needs areas like DSNP, ABD, and complex populations
* Proposal Support & Competitive Differentiation
* Serve as an expert on the pre-procurement process for the proposal team and closely collaborate with the Proposal Director to ensure consistency between market strategy, capture strategy and proposal content. Collaborate with the Proposal Director to ensure consistency between market strategy and RFP content
* Track and support the execution of win strategy and strategic recommendations being incorporated throughout the proposal, ensuring Molina's proposals are differentiated and align with state-specific priorities and the competitive landscape
* Actively participate in blue, pink, and red team reviews, providing strategic feedback to ensure proposal materials effectively communicate Molina's competitive advantages and compliance with RFP requirements
* Support orals preparation, working across matrix partners to refine materials and messaging for presentations to state agencies
* Operational Excellence & Cross-Functional Coordination
* Use tools (i.e. Salesforce) to document market intelligence, track engagement activities, and share insights across departments. Ensure that data-driven insights are leveraged in proposal content development and strategic planning
* Collaborate with the Growth Strategy, Competitive Intelligence and other stakeholders to leverage the competitive intelligence repository that informs decision-making and provides a strategic edge in Medicaid procurements
* Develop project plans and roadmaps to guide the timely execution of pre-RFP and procurement activities, ensuring effective collaboration and alignment across functional teams
* Facilitate cross-functional coordination for market entry, retention, and development strategies, ensuring that all teams are aligned and executing efficiently
* Supports the VP Business Development as a SME during the "warranty period" post award through implementation to the IMO and health plan leadership
* Mentorship & Team Development
* Mentor junior staff and interns within the Business Development teams, fostering skills in strategic thinking, market research, and pre-procurement planning
* Participate in business development activities on an ad-hoc basis, contributing to team knowledge and providing strategic insights to senior leadership
* 50% or more Travel required
Job Qualifications
REQUIRED QUALIFICATIONS:
* Bachelor's degree in business, Public Policy, Healthcare Administration or a related field or equivalent combination of education and experience
* 7 years in market strategy, business development, or healthcare consulting, specifically within Medicaid managed care or equivalent related field
* Proven experience in pre-RFP strategy development, with a strong understanding of Medicaid programs, including TANF, ABD, DSNP, and CHIP populations
* Demonstrated ability to drive innovative solutions in the Medicaid space, leveraging market research and industry trends to inform strategic decisions
* Experience with Salesforce or similar tools to track market insights, engagement activities, and manage data
* Strong experience in stakeholder engagement, particularly with state Medicaid agencies, regulatory bodies, and community-based organizations
* Advanced proficiency in Microsoft Office tools (Excel, PowerPoint, Word), including for strategy development, data analysis, and presentation creation
PREFERRED QUALIFICATIONS:
* Master's degree (MBA, MPH, MPA) in business, public policy, or healthcare administration
* 7+ years in business development and Medicaid procurements, particularly with complex populations (e.g., DD/IDD, Foster Care, Dual-Eligible Members)
* Experience with Salesforce or similar tools to track market insights, engagement activities, and manage data
* Conference management experience and participation in industry forums
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: $107,028 - $208,705 / ANNUAL
* Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
$107k-208.7k yearly 15d ago
Strategy Advancement Director
Molina Healthcare Inc. 4.4
Akron, OH jobs
The Strategy Advancement Director is responsible for advancing Molina's growth strategy and positioning the company for success in Medicaid, CHIP, DSNP, and Marketplace procurements. Reporting to the VicePresident, Business Development, this position plays a pivotal role in the pre-RFP and procurement phases, guiding and organizing the project, ensuring deliverables are met, conducting research, tracking Business Development and/or Health Plan steps and projects, owning the governance structure for every opportunity, pulling together all the supporting team activities and pieces and connecting the dots between winning strategy and the relationships and partnerships developed by the VP, Business Development.
This role requires a deep understanding of Medicaid programs, the regulatory environment, and the unique challenges of populations (i.e. TANF, ABD, DSNP, Foster Care, and DD/IDD). The Strategy Advancement Director works collaboratively across departments, including Product Development, Business Development, and Health Plans, to ensure that strategic initiatives align with state-specific priorities and are positioned for success in competitive procurements. The Director partners with the VP Market Development to provide thought leadership and subject matter expertise, identifying trends, providing insights, and continuously innovating to strengthen Molina's market position.
Job Duties
* Strategy Development & Innovation
* Collaborate on the development of state-specific strategies aligned with state priorities, procurement objectives, and evolving Medicaid needs. Translate state regulatory requirements into actionable go-to-market strategies that are innovative and differentiate Molina in competitive procurements
* Collaborate with Product Development, Health Plan leaders, Growth Leaders and cross-functional teams to support integration of innovative care models, operational efficiencies, and value-based care solutions tailored to the unique needs of market specific Medicaid populations, especially high-risk or vulnerable groups such as dual-eligible members, foster care, and ABD
* Conduct market research, analyze industry trends, and monitor competitor activities to identify innovation opportunities. Propose solutions that address Medicaid ecosystem pain points and enhance Molina's value proposition
* Use insights from market research and competitive analysis to stay informed on state Medicaid trends, regulatory changes, and market conditions, and to guide strategic adjustments and future market positioning
* Drive the development of win themes and strategy recommendations that align with state priorities, competitive dynamics, and the latest Medicaid trends, positioning Molina as a leader in Medicaid managed care
* Track regulatory compliance and address any operational concerns or state-specific issues identified during the pre-procurement phase. Escalate issues when necessary and work to resolve them proactively
* Market Development and Strategy Execution
* Collaborate on the development of pre-RFP strategy and market readiness, creating and tracking playbooks, plans, and deliverables for Molina's strategy two to three years before RFP release. Ensure alignment with organizational goals and state requirements by collaborating with Market VPs, AVPs, and stakeholders
* Identify and engage in thought leadership opportunities by representing Molina at state and national Medicaid conferences, industry forums, and other key events that enhance Molina's brand and expertise in Medicaid care delivery
* Stakeholder Engagement & Thought Leadership
* Support and track the development of relationships with state agencies, legislative leaders, regulatory bodies, and community organizations to enhance Molina's reputation and strengthen partnerships that could influence procurement outcomes
* Represent Molina in strategic discussions with external partners and internal leadership, ensuring clear communication of strategy, innovation, and value propositions
* Collaborate with internal stakeholders to influence thought leadership materials and content that showcase Molina's innovative approaches to Medicaid, particularly in high-needs areas like DSNP, ABD, and complex populations
* Proposal Support & Competitive Differentiation
* Serve as an expert on the pre-procurement process for the proposal team and closely collaborate with the Proposal Director to ensure consistency between market strategy, capture strategy and proposal content. Collaborate with the Proposal Director to ensure consistency between market strategy and RFP content
* Track and support the execution of win strategy and strategic recommendations being incorporated throughout the proposal, ensuring Molina's proposals are differentiated and align with state-specific priorities and the competitive landscape
* Actively participate in blue, pink, and red team reviews, providing strategic feedback to ensure proposal materials effectively communicate Molina's competitive advantages and compliance with RFP requirements
* Support orals preparation, working across matrix partners to refine materials and messaging for presentations to state agencies
* Operational Excellence & Cross-Functional Coordination
* Use tools (i.e. Salesforce) to document market intelligence, track engagement activities, and share insights across departments. Ensure that data-driven insights are leveraged in proposal content development and strategic planning
* Collaborate with the Growth Strategy, Competitive Intelligence and other stakeholders to leverage the competitive intelligence repository that informs decision-making and provides a strategic edge in Medicaid procurements
* Develop project plans and roadmaps to guide the timely execution of pre-RFP and procurement activities, ensuring effective collaboration and alignment across functional teams
* Facilitate cross-functional coordination for market entry, retention, and development strategies, ensuring that all teams are aligned and executing efficiently
* Supports the VP Business Development as a SME during the "warranty period" post award through implementation to the IMO and health plan leadership
* Mentorship & Team Development
* Mentor junior staff and interns within the Business Development teams, fostering skills in strategic thinking, market research, and pre-procurement planning
* Participate in business development activities on an ad-hoc basis, contributing to team knowledge and providing strategic insights to senior leadership
* 50% or more Travel required
Job Qualifications
REQUIRED QUALIFICATIONS:
* Bachelor's degree in business, Public Policy, Healthcare Administration or a related field or equivalent combination of education and experience
* 7 years in market strategy, business development, or healthcare consulting, specifically within Medicaid managed care or equivalent related field
* Proven experience in pre-RFP strategy development, with a strong understanding of Medicaid programs, including TANF, ABD, DSNP, and CHIP populations
* Demonstrated ability to drive innovative solutions in the Medicaid space, leveraging market research and industry trends to inform strategic decisions
* Experience with Salesforce or similar tools to track market insights, engagement activities, and manage data
* Strong experience in stakeholder engagement, particularly with state Medicaid agencies, regulatory bodies, and community-based organizations
* Advanced proficiency in Microsoft Office tools (Excel, PowerPoint, Word), including for strategy development, data analysis, and presentation creation
PREFERRED QUALIFICATIONS:
* Master's degree (MBA, MPH, MPA) in business, public policy, or healthcare administration
* 7+ years in business development and Medicaid procurements, particularly with complex populations (e.g., DD/IDD, Foster Care, Dual-Eligible Members)
* Experience with Salesforce or similar tools to track market insights, engagement activities, and manage data
* Conference management experience and participation in industry forums
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: $107,028 - $208,705 / ANNUAL
* Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
$107k-208.7k yearly 15d ago
Strategy Advancement Director
Molina Healthcare Inc. 4.4
Cincinnati, OH jobs
The Strategy Advancement Director is responsible for advancing Molina's growth strategy and positioning the company for success in Medicaid, CHIP, DSNP, and Marketplace procurements. Reporting to the VicePresident, Business Development, this position plays a pivotal role in the pre-RFP and procurement phases, guiding and organizing the project, ensuring deliverables are met, conducting research, tracking Business Development and/or Health Plan steps and projects, owning the governance structure for every opportunity, pulling together all the supporting team activities and pieces and connecting the dots between winning strategy and the relationships and partnerships developed by the VP, Business Development.
This role requires a deep understanding of Medicaid programs, the regulatory environment, and the unique challenges of populations (i.e. TANF, ABD, DSNP, Foster Care, and DD/IDD). The Strategy Advancement Director works collaboratively across departments, including Product Development, Business Development, and Health Plans, to ensure that strategic initiatives align with state-specific priorities and are positioned for success in competitive procurements. The Director partners with the VP Market Development to provide thought leadership and subject matter expertise, identifying trends, providing insights, and continuously innovating to strengthen Molina's market position.
Job Duties
* Strategy Development & Innovation
* Collaborate on the development of state-specific strategies aligned with state priorities, procurement objectives, and evolving Medicaid needs. Translate state regulatory requirements into actionable go-to-market strategies that are innovative and differentiate Molina in competitive procurements
* Collaborate with Product Development, Health Plan leaders, Growth Leaders and cross-functional teams to support integration of innovative care models, operational efficiencies, and value-based care solutions tailored to the unique needs of market specific Medicaid populations, especially high-risk or vulnerable groups such as dual-eligible members, foster care, and ABD
* Conduct market research, analyze industry trends, and monitor competitor activities to identify innovation opportunities. Propose solutions that address Medicaid ecosystem pain points and enhance Molina's value proposition
* Use insights from market research and competitive analysis to stay informed on state Medicaid trends, regulatory changes, and market conditions, and to guide strategic adjustments and future market positioning
* Drive the development of win themes and strategy recommendations that align with state priorities, competitive dynamics, and the latest Medicaid trends, positioning Molina as a leader in Medicaid managed care
* Track regulatory compliance and address any operational concerns or state-specific issues identified during the pre-procurement phase. Escalate issues when necessary and work to resolve them proactively
* Market Development and Strategy Execution
* Collaborate on the development of pre-RFP strategy and market readiness, creating and tracking playbooks, plans, and deliverables for Molina's strategy two to three years before RFP release. Ensure alignment with organizational goals and state requirements by collaborating with Market VPs, AVPs, and stakeholders
* Identify and engage in thought leadership opportunities by representing Molina at state and national Medicaid conferences, industry forums, and other key events that enhance Molina's brand and expertise in Medicaid care delivery
* Stakeholder Engagement & Thought Leadership
* Support and track the development of relationships with state agencies, legislative leaders, regulatory bodies, and community organizations to enhance Molina's reputation and strengthen partnerships that could influence procurement outcomes
* Represent Molina in strategic discussions with external partners and internal leadership, ensuring clear communication of strategy, innovation, and value propositions
* Collaborate with internal stakeholders to influence thought leadership materials and content that showcase Molina's innovative approaches to Medicaid, particularly in high-needs areas like DSNP, ABD, and complex populations
* Proposal Support & Competitive Differentiation
* Serve as an expert on the pre-procurement process for the proposal team and closely collaborate with the Proposal Director to ensure consistency between market strategy, capture strategy and proposal content. Collaborate with the Proposal Director to ensure consistency between market strategy and RFP content
* Track and support the execution of win strategy and strategic recommendations being incorporated throughout the proposal, ensuring Molina's proposals are differentiated and align with state-specific priorities and the competitive landscape
* Actively participate in blue, pink, and red team reviews, providing strategic feedback to ensure proposal materials effectively communicate Molina's competitive advantages and compliance with RFP requirements
* Support orals preparation, working across matrix partners to refine materials and messaging for presentations to state agencies
* Operational Excellence & Cross-Functional Coordination
* Use tools (i.e. Salesforce) to document market intelligence, track engagement activities, and share insights across departments. Ensure that data-driven insights are leveraged in proposal content development and strategic planning
* Collaborate with the Growth Strategy, Competitive Intelligence and other stakeholders to leverage the competitive intelligence repository that informs decision-making and provides a strategic edge in Medicaid procurements
* Develop project plans and roadmaps to guide the timely execution of pre-RFP and procurement activities, ensuring effective collaboration and alignment across functional teams
* Facilitate cross-functional coordination for market entry, retention, and development strategies, ensuring that all teams are aligned and executing efficiently
* Supports the VP Business Development as a SME during the "warranty period" post award through implementation to the IMO and health plan leadership
* Mentorship & Team Development
* Mentor junior staff and interns within the Business Development teams, fostering skills in strategic thinking, market research, and pre-procurement planning
* Participate in business development activities on an ad-hoc basis, contributing to team knowledge and providing strategic insights to senior leadership
* 50% or more Travel required
Job Qualifications
REQUIRED QUALIFICATIONS:
* Bachelor's degree in business, Public Policy, Healthcare Administration or a related field or equivalent combination of education and experience
* 7 years in market strategy, business development, or healthcare consulting, specifically within Medicaid managed care or equivalent related field
* Proven experience in pre-RFP strategy development, with a strong understanding of Medicaid programs, including TANF, ABD, DSNP, and CHIP populations
* Demonstrated ability to drive innovative solutions in the Medicaid space, leveraging market research and industry trends to inform strategic decisions
* Experience with Salesforce or similar tools to track market insights, engagement activities, and manage data
* Strong experience in stakeholder engagement, particularly with state Medicaid agencies, regulatory bodies, and community-based organizations
* Advanced proficiency in Microsoft Office tools (Excel, PowerPoint, Word), including for strategy development, data analysis, and presentation creation
PREFERRED QUALIFICATIONS:
* Master's degree (MBA, MPH, MPA) in business, public policy, or healthcare administration
* 7+ years in business development and Medicaid procurements, particularly with complex populations (e.g., DD/IDD, Foster Care, Dual-Eligible Members)
* Experience with Salesforce or similar tools to track market insights, engagement activities, and manage data
* Conference management experience and participation in industry forums
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: $107,028 - $208,705 / ANNUAL
* Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
$107k-208.7k yearly 15d ago
Strategy Advancement Director
Molina Healthcare Inc. 4.4
Dayton, OH jobs
The Strategy Advancement Director is responsible for advancing Molina's growth strategy and positioning the company for success in Medicaid, CHIP, DSNP, and Marketplace procurements. Reporting to the VicePresident, Business Development, this position plays a pivotal role in the pre-RFP and procurement phases, guiding and organizing the project, ensuring deliverables are met, conducting research, tracking Business Development and/or Health Plan steps and projects, owning the governance structure for every opportunity, pulling together all the supporting team activities and pieces and connecting the dots between winning strategy and the relationships and partnerships developed by the VP, Business Development.
This role requires a deep understanding of Medicaid programs, the regulatory environment, and the unique challenges of populations (i.e. TANF, ABD, DSNP, Foster Care, and DD/IDD). The Strategy Advancement Director works collaboratively across departments, including Product Development, Business Development, and Health Plans, to ensure that strategic initiatives align with state-specific priorities and are positioned for success in competitive procurements. The Director partners with the VP Market Development to provide thought leadership and subject matter expertise, identifying trends, providing insights, and continuously innovating to strengthen Molina's market position.
Job Duties
* Strategy Development & Innovation
* Collaborate on the development of state-specific strategies aligned with state priorities, procurement objectives, and evolving Medicaid needs. Translate state regulatory requirements into actionable go-to-market strategies that are innovative and differentiate Molina in competitive procurements
* Collaborate with Product Development, Health Plan leaders, Growth Leaders and cross-functional teams to support integration of innovative care models, operational efficiencies, and value-based care solutions tailored to the unique needs of market specific Medicaid populations, especially high-risk or vulnerable groups such as dual-eligible members, foster care, and ABD
* Conduct market research, analyze industry trends, and monitor competitor activities to identify innovation opportunities. Propose solutions that address Medicaid ecosystem pain points and enhance Molina's value proposition
* Use insights from market research and competitive analysis to stay informed on state Medicaid trends, regulatory changes, and market conditions, and to guide strategic adjustments and future market positioning
* Drive the development of win themes and strategy recommendations that align with state priorities, competitive dynamics, and the latest Medicaid trends, positioning Molina as a leader in Medicaid managed care
* Track regulatory compliance and address any operational concerns or state-specific issues identified during the pre-procurement phase. Escalate issues when necessary and work to resolve them proactively
* Market Development and Strategy Execution
* Collaborate on the development of pre-RFP strategy and market readiness, creating and tracking playbooks, plans, and deliverables for Molina's strategy two to three years before RFP release. Ensure alignment with organizational goals and state requirements by collaborating with Market VPs, AVPs, and stakeholders
* Identify and engage in thought leadership opportunities by representing Molina at state and national Medicaid conferences, industry forums, and other key events that enhance Molina's brand and expertise in Medicaid care delivery
* Stakeholder Engagement & Thought Leadership
* Support and track the development of relationships with state agencies, legislative leaders, regulatory bodies, and community organizations to enhance Molina's reputation and strengthen partnerships that could influence procurement outcomes
* Represent Molina in strategic discussions with external partners and internal leadership, ensuring clear communication of strategy, innovation, and value propositions
* Collaborate with internal stakeholders to influence thought leadership materials and content that showcase Molina's innovative approaches to Medicaid, particularly in high-needs areas like DSNP, ABD, and complex populations
* Proposal Support & Competitive Differentiation
* Serve as an expert on the pre-procurement process for the proposal team and closely collaborate with the Proposal Director to ensure consistency between market strategy, capture strategy and proposal content. Collaborate with the Proposal Director to ensure consistency between market strategy and RFP content
* Track and support the execution of win strategy and strategic recommendations being incorporated throughout the proposal, ensuring Molina's proposals are differentiated and align with state-specific priorities and the competitive landscape
* Actively participate in blue, pink, and red team reviews, providing strategic feedback to ensure proposal materials effectively communicate Molina's competitive advantages and compliance with RFP requirements
* Support orals preparation, working across matrix partners to refine materials and messaging for presentations to state agencies
* Operational Excellence & Cross-Functional Coordination
* Use tools (i.e. Salesforce) to document market intelligence, track engagement activities, and share insights across departments. Ensure that data-driven insights are leveraged in proposal content development and strategic planning
* Collaborate with the Growth Strategy, Competitive Intelligence and other stakeholders to leverage the competitive intelligence repository that informs decision-making and provides a strategic edge in Medicaid procurements
* Develop project plans and roadmaps to guide the timely execution of pre-RFP and procurement activities, ensuring effective collaboration and alignment across functional teams
* Facilitate cross-functional coordination for market entry, retention, and development strategies, ensuring that all teams are aligned and executing efficiently
* Supports the VP Business Development as a SME during the "warranty period" post award through implementation to the IMO and health plan leadership
* Mentorship & Team Development
* Mentor junior staff and interns within the Business Development teams, fostering skills in strategic thinking, market research, and pre-procurement planning
* Participate in business development activities on an ad-hoc basis, contributing to team knowledge and providing strategic insights to senior leadership
* 50% or more Travel required
Job Qualifications
REQUIRED QUALIFICATIONS:
* Bachelor's degree in business, Public Policy, Healthcare Administration or a related field or equivalent combination of education and experience
* 7 years in market strategy, business development, or healthcare consulting, specifically within Medicaid managed care or equivalent related field
* Proven experience in pre-RFP strategy development, with a strong understanding of Medicaid programs, including TANF, ABD, DSNP, and CHIP populations
* Demonstrated ability to drive innovative solutions in the Medicaid space, leveraging market research and industry trends to inform strategic decisions
* Experience with Salesforce or similar tools to track market insights, engagement activities, and manage data
* Strong experience in stakeholder engagement, particularly with state Medicaid agencies, regulatory bodies, and community-based organizations
* Advanced proficiency in Microsoft Office tools (Excel, PowerPoint, Word), including for strategy development, data analysis, and presentation creation
PREFERRED QUALIFICATIONS:
* Master's degree (MBA, MPH, MPA) in business, public policy, or healthcare administration
* 7+ years in business development and Medicaid procurements, particularly with complex populations (e.g., DD/IDD, Foster Care, Dual-Eligible Members)
* Experience with Salesforce or similar tools to track market insights, engagement activities, and manage data
* Conference management experience and participation in industry forums
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: $107,028 - $208,705 / ANNUAL
* Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
$107k-208.7k yearly 15d ago
Strategy Advancement Director
Molina Healthcare Inc. 4.4
Ohio jobs
The Strategy Advancement Director is responsible for advancing Molina's growth strategy and positioning the company for success in Medicaid, CHIP, DSNP, and Marketplace procurements. Reporting to the VicePresident, Business Development, this position plays a pivotal role in the pre-RFP and procurement phases, guiding and organizing the project, ensuring deliverables are met, conducting research, tracking Business Development and/or Health Plan steps and projects, owning the governance structure for every opportunity, pulling together all the supporting team activities and pieces and connecting the dots between winning strategy and the relationships and partnerships developed by the VP, Business Development.
This role requires a deep understanding of Medicaid programs, the regulatory environment, and the unique challenges of populations (i.e. TANF, ABD, DSNP, Foster Care, and DD/IDD). The Strategy Advancement Director works collaboratively across departments, including Product Development, Business Development, and Health Plans, to ensure that strategic initiatives align with state-specific priorities and are positioned for success in competitive procurements. The Director partners with the VP Market Development to provide thought leadership and subject matter expertise, identifying trends, providing insights, and continuously innovating to strengthen Molina's market position.
Job Duties
* Strategy Development & Innovation
* Collaborate on the development of state-specific strategies aligned with state priorities, procurement objectives, and evolving Medicaid needs. Translate state regulatory requirements into actionable go-to-market strategies that are innovative and differentiate Molina in competitive procurements
* Collaborate with Product Development, Health Plan leaders, Growth Leaders and cross-functional teams to support integration of innovative care models, operational efficiencies, and value-based care solutions tailored to the unique needs of market specific Medicaid populations, especially high-risk or vulnerable groups such as dual-eligible members, foster care, and ABD
* Conduct market research, analyze industry trends, and monitor competitor activities to identify innovation opportunities. Propose solutions that address Medicaid ecosystem pain points and enhance Molina's value proposition
* Use insights from market research and competitive analysis to stay informed on state Medicaid trends, regulatory changes, and market conditions, and to guide strategic adjustments and future market positioning
* Drive the development of win themes and strategy recommendations that align with state priorities, competitive dynamics, and the latest Medicaid trends, positioning Molina as a leader in Medicaid managed care
* Track regulatory compliance and address any operational concerns or state-specific issues identified during the pre-procurement phase. Escalate issues when necessary and work to resolve them proactively
* Market Development and Strategy Execution
* Collaborate on the development of pre-RFP strategy and market readiness, creating and tracking playbooks, plans, and deliverables for Molina's strategy two to three years before RFP release. Ensure alignment with organizational goals and state requirements by collaborating with Market VPs, AVPs, and stakeholders
* Identify and engage in thought leadership opportunities by representing Molina at state and national Medicaid conferences, industry forums, and other key events that enhance Molina's brand and expertise in Medicaid care delivery
* Stakeholder Engagement & Thought Leadership
* Support and track the development of relationships with state agencies, legislative leaders, regulatory bodies, and community organizations to enhance Molina's reputation and strengthen partnerships that could influence procurement outcomes
* Represent Molina in strategic discussions with external partners and internal leadership, ensuring clear communication of strategy, innovation, and value propositions
* Collaborate with internal stakeholders to influence thought leadership materials and content that showcase Molina's innovative approaches to Medicaid, particularly in high-needs areas like DSNP, ABD, and complex populations
* Proposal Support & Competitive Differentiation
* Serve as an expert on the pre-procurement process for the proposal team and closely collaborate with the Proposal Director to ensure consistency between market strategy, capture strategy and proposal content. Collaborate with the Proposal Director to ensure consistency between market strategy and RFP content
* Track and support the execution of win strategy and strategic recommendations being incorporated throughout the proposal, ensuring Molina's proposals are differentiated and align with state-specific priorities and the competitive landscape
* Actively participate in blue, pink, and red team reviews, providing strategic feedback to ensure proposal materials effectively communicate Molina's competitive advantages and compliance with RFP requirements
* Support orals preparation, working across matrix partners to refine materials and messaging for presentations to state agencies
* Operational Excellence & Cross-Functional Coordination
* Use tools (i.e. Salesforce) to document market intelligence, track engagement activities, and share insights across departments. Ensure that data-driven insights are leveraged in proposal content development and strategic planning
* Collaborate with the Growth Strategy, Competitive Intelligence and other stakeholders to leverage the competitive intelligence repository that informs decision-making and provides a strategic edge in Medicaid procurements
* Develop project plans and roadmaps to guide the timely execution of pre-RFP and procurement activities, ensuring effective collaboration and alignment across functional teams
* Facilitate cross-functional coordination for market entry, retention, and development strategies, ensuring that all teams are aligned and executing efficiently
* Supports the VP Business Development as a SME during the "warranty period" post award through implementation to the IMO and health plan leadership
* Mentorship & Team Development
* Mentor junior staff and interns within the Business Development teams, fostering skills in strategic thinking, market research, and pre-procurement planning
* Participate in business development activities on an ad-hoc basis, contributing to team knowledge and providing strategic insights to senior leadership
* 50% or more Travel required
Job Qualifications
REQUIRED QUALIFICATIONS:
* Bachelor's degree in business, Public Policy, Healthcare Administration or a related field or equivalent combination of education and experience
* 7 years in market strategy, business development, or healthcare consulting, specifically within Medicaid managed care or equivalent related field
* Proven experience in pre-RFP strategy development, with a strong understanding of Medicaid programs, including TANF, ABD, DSNP, and CHIP populations
* Demonstrated ability to drive innovative solutions in the Medicaid space, leveraging market research and industry trends to inform strategic decisions
* Experience with Salesforce or similar tools to track market insights, engagement activities, and manage data
* Strong experience in stakeholder engagement, particularly with state Medicaid agencies, regulatory bodies, and community-based organizations
* Advanced proficiency in Microsoft Office tools (Excel, PowerPoint, Word), including for strategy development, data analysis, and presentation creation
PREFERRED QUALIFICATIONS:
* Master's degree (MBA, MPH, MPA) in business, public policy, or healthcare administration
* 7+ years in business development and Medicaid procurements, particularly with complex populations (e.g., DD/IDD, Foster Care, Dual-Eligible Members)
* Experience with Salesforce or similar tools to track market insights, engagement activities, and manage data
* Conference management experience and participation in industry forums
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: $107,028 - $208,705 / ANNUAL
* Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
$107k-208.7k yearly 15d ago
Strategy Advancement Director
Molina Healthcare 4.4
Ohio jobs
The Strategy Advancement Director is responsible for advancing Molina's growth strategy and positioning the company for success in Medicaid, CHIP, DSNP, and Marketplace procurements. Reporting to the VicePresident, Business Development, this position plays a pivotal role in the pre-RFP and procurement phases, guiding and organizing the project, ensuring deliverables are met, conducting research, tracking Business Development and/or Health Plan steps and projects, owning the governance structure for every opportunity, pulling together all the supporting team activities and pieces and connecting the dots between winning strategy and the relationships and partnerships developed by the VP, Business Development.
This role requires a deep understanding of Medicaid programs, the regulatory environment, and the unique challenges of populations (i.e. TANF, ABD, DSNP, Foster Care, and DD/IDD). The Strategy Advancement Director works collaboratively across departments, including Product Development, Business Development, and Health Plans, to ensure that strategic initiatives align with state-specific priorities and are positioned for success in competitive procurements. The Director partners with the VP Market Development to provide thought leadership and subject matter expertise, identifying trends, providing insights, and continuously innovating to strengthen Molina's market position.
**Job Duties**
+ Strategy Development & Innovation
+ Collaborate on the development of state-specific strategies aligned with state priorities, procurement objectives, and evolving Medicaid needs. Translate state regulatory requirements into actionable go-to-market strategies that are innovative and differentiate Molina in competitive procurements
+ Collaborate with Product Development, Health Plan leaders, Growth Leaders and cross-functional teams to support integration of innovative care models, operational efficiencies, and value-based care solutions tailored to the unique needs of market specific Medicaid populations, especially high-risk or vulnerable groups such as dual-eligible members, foster care, and ABD
+ Conduct market research, analyze industry trends, and monitor competitor activities to identify innovation opportunities. Propose solutions that address Medicaid ecosystem pain points and enhance Molina's value proposition
+ Use insights from market research and competitive analysis to stay informed on state Medicaid trends, regulatory changes, and market conditions, and to guide strategic adjustments and future market positioning
+ Drive the development of win themes and strategy recommendations that align with state priorities, competitive dynamics, and the latest Medicaid trends, positioning Molina as a leader in Medicaid managed care
+ Track regulatory compliance and address any operational concerns or state-specific issues identified during the pre-procurement phase. Escalate issues when necessary and work to resolve them proactively
+ Market Development and Strategy Execution
+ Collaborate on the development of pre-RFP strategy and market readiness, creating and tracking playbooks, plans, and deliverables for Molina's strategy two to three years before RFP release. Ensure alignment with organizational goals and state requirements by collaborating with Market VPs, AVPs, and stakeholders
+ Identify and engage in thought leadership opportunities by representing Molina at state and national Medicaid conferences, industry forums, and other key events that enhance Molina's brand and expertise in Medicaid care delivery
+ Stakeholder Engagement & Thought Leadership
+ Support and track the development of relationships with state agencies, legislative leaders, regulatory bodies, and community organizations to enhance Molina's reputation and strengthen partnerships that could influence procurement outcomes
+ Represent Molina in strategic discussions with external partners and internal leadership, ensuring clear communication of strategy, innovation, and value propositions
+ Collaborate with internal stakeholders to influence thought leadership materials and content that showcase Molina's innovative approaches to Medicaid, particularly in high-needs areas like DSNP, ABD, and complex populations
+ Proposal Support & Competitive Differentiation
+ Serve as an expert on the pre-procurement process for the proposal team and closely collaborate with the Proposal Director to ensure consistency between market strategy, capture strategy and proposal content. Collaborate with the Proposal Director to ensure consistency between market strategy and RFP content
+ Track and support the execution of win strategy and strategic recommendations being incorporated throughout the proposal, ensuring Molina's proposals are differentiated and align with state-specific priorities and the competitive landscape
+ Actively participate in blue, pink, and red team reviews, providing strategic feedback to ensure proposal materials effectively communicate Molina's competitive advantages and compliance with RFP requirements
+ Support orals preparation, working across matrix partners to refine materials and messaging for presentations to state agencies
+ Operational Excellence & Cross-Functional Coordination
+ Use tools (i.e. Salesforce) to document market intelligence, track engagement activities, and share insights across departments. Ensure that data-driven insights are leveraged in proposal content development and strategic planning
+ Collaborate with the Growth Strategy, Competitive Intelligence and other stakeholders to leverage the competitive intelligence repository that informs decision-making and provides a strategic edge in Medicaid procurements
+ Develop project plans and roadmaps to guide the timely execution of pre-RFP and procurement activities, ensuring effective collaboration and alignment across functional teams
+ Facilitate cross-functional coordination for market entry, retention, and development strategies, ensuring that all teams are aligned and executing efficiently
+ Supports the VP Business Development as a SME during the "warranty period" post award through implementation to the IMO and health plan leadership
+ Mentorship & Team Development
+ Mentor junior staff and interns within the Business Development teams, fostering skills in strategic thinking, market research, and pre-procurement planning
+ Participate in business development activities on an ad-hoc basis, contributing to team knowledge and providing strategic insights to senior leadership
+ 50% or more Travel required
**Job Qualifications**
**REQUIRED QUALIFICATIONS:**
+ Bachelor's degree in business, Public Policy, Healthcare Administration or a related field or equivalent combination of education and experience
+ 7 years in market strategy, business development, or healthcare consulting, specifically within Medicaid managed care or equivalent related field
+ Proven experience in pre-RFP strategy development, with a strong understanding of Medicaid programs, including TANF, ABD, DSNP, and CHIP populations
+ Demonstrated ability to drive innovative solutions in the Medicaid space, leveraging market research and industry trends to inform strategic decisions
+ Experience with Salesforce or similar tools to track market insights, engagement activities, and manage data
+ Strong experience in stakeholder engagement, particularly with state Medicaid agencies, regulatory bodies, and community-based organizations
+ Advanced proficiency in Microsoft Office tools (Excel, PowerPoint, Word), including for strategy development, data analysis, and presentation creation
**PREFERRED QUALIFICATIONS:**
+ Master's degree (MBA, MPH, MPA) in business, public policy, or healthcare administration
+ 7+ years in business development and Medicaid procurements, particularly with complex populations (e.g., DD/IDD, Foster Care, Dual-Eligible Members)
+ Experience with Salesforce or similar tools to track market insights, engagement activities, and manage data
+ Conference management experience and participation in industry forums
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: $107,028 - $208,705 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.