VP, Clinical System Implementation & Improvement - Molina Healthcare : Job Details
VP, Clinical System Implementation & Improvement
Molina HealthcareJob Location : all cities,NM, USA
Join to apply for the VP, Clinical System Implementation & Improvement role at Molina Healthcare
VP, Clinical System Implementation & ImprovementJoin to apply for the VP, Clinical System Implementation & Improvement role at Molina Healthcare
Job SummaryLeads clinical systems, automation, integration, implementation and process improvement initiatives that result in operational efficiencies and/or an increase in customer satisfaction. Assists in development of MHI's business process improvement methodology and in the implementation of a business process improvement capability. Responsible for evaluating existing processes and configuring clinical systems to reduce cost and develop best practices within clinical programs.
Job DescriptionJob SummaryLeads clinical systems, automation, integration, implementation and process improvement initiatives that result in operational efficiencies and/or an increase in customer satisfaction. Assists in development of MHI's business process improvement methodology and in the implementation of a business process improvement capability. Responsible for evaluating existing processes and configuring clinical systems to reduce cost and develop best practices within clinical programs.Knowledge/Skills/Abilities
- Optimizes and improves clinical systems, business processes and productivity using understanding of key revenue levers, cost drivers and customer satisfaction impacts of business processes
- Leads process improvement initiatives and implementation with defined objectives and measurable results
- Works with business sponsors to develop clear definitions of business process improvement opportunities and establish measurable goals/objectives
- Engages cross-functional areas & health plans (e.g. product, configuration, UM, Care Management, provider network, claims) for requirements planning
- Makes recommendations on scope and priorities for improvement initiatives, assesses for opportunities for vendor solutions.
- Develops and optimizes processes to achieve the output, quality, and cost goals of the organization.
- Plans and executes process improvement initiatives, leading work streams of significant scope, typically requiring cross-functional integration
- Focuses on improving operational fundamentals and effectiveness; uses expertise to make operating processes more nimble and sustainable
- Ensures that on-going work following a system implementation or improvement initiative is identified, planned, assigned and successfully deployed
- Researches and engages industry, evaluates, and provides industry insights, competitor best practices as applicable for adoption or use by Molina
- Conducts or coordinates post-implementation initiative review to measure results and report to health plan partners, senior management & stakeholders
- Provides summary analysis of clinical systems automation, implementation, integration and compliance based issues, to influence product revisions
- Coaches and mentors other Molina leaders and staff in the system application of business process improvement, implementation and intergration
- Manages a team of product owners, Program Managers and Subject Matter Experts responsible for implementation of approved initiatives
- Responsible for coaching the team on Agile, Scrum, Quality Improvement methodologies for application on enterprise initiatives
- Builds company specific systems and technology expertise across multiple infrastructure and development disciplines.
- Responsible for areas of strategic planning for architecture standards, roadmaps, budgets, programs and projects.
- Responsible for providing expertise of major industry trends such as cloud technologies, automation, agile methodologies, etc.
- Ownership to provide cross-organization teamwork, collaboration, communication and leadership.
- Provides constructive feedback on people, process and technology for continuous improvement.
- Relationship building with IT leadership, technical engineers, program managers, support leads, and external vendors to understand and solve problems. Accountable for insuring compliance with contractual, accreditation and regulatory requirements
- Partners with Compliance to ensure system features impacting regulatory requirements are addressed via a Corrective Action Plan in collaboration with IT..
- 10 years minimum experience in Healthcare.
- Extensive management level experience or understanding of all areas of health plan operations: claims processing, customer service/call center, provider contracting, benefit design and configuration, product development, membership accounting and enrollment, operational systems, provider contracting, authorizations/referrals, utilization management.
- Understands key revenue levers and cost drivers of business processes.
- Understands critical success factors for the industry.
- Experience designing and delivering solutions related to operational improvement functions.
- Experience implementing new systems and systems processes
- Strong leadership qualities and ability to get results.
- Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
- Seniority levelExecutive
- Employment typeFull-time
- Job functionManagement and Manufacturing
- IndustriesHospitals and Health Care
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