Job Description

This role will act as an advocate for Molina members and a subject matter expert about members’ extra benefits and covered services. The overarching driver will be increasing member retention and member satisfaction, and facilitating improvements in the health plan. Uses data sources like member utilization, satisfaction, and operational inputs to drive improvement in the member experience.

Represents member perspective in areas involving member impact and engagement. Oversees, tracks, and reports on value-added benefits for Medicaid and MyCare Ohio. Partners with state and enterprise vendor teams to ensure benefit integrity.

Knowledge/Skills/Abilities

• Represents member issues in areas involving value-added benefits and their impact on member experience.
• Serves as an advocate for Molina members in working with health plan and enterprise departments, as well as external stakeholders as appropriate, including community-based organizations and regulator partners.
• Acts as a subject matter expert for Medicaid and MyCare Ohio value-added benefits to audiences both internal and external to Molina.
• Supports the provision of our plan’s extra benefits, particularly the Medicaid and MyCare Ohio extra benefits. This includes tracking and reporting on utilization and other key performance indicators; it includes representing member issues and the member experience with our benefits.
• Investigates member complaints related to the value-added benefits, including working collaboratively with the Appeals & Grievances team and with the Medicare teams that investigate complaints submitted via the CMS Complaints Tracking Module (CTM).
• Facilitates and/or attends value-added benefit workgroups at both the health plan and enterprise levels. Presents internally in cross-functional forums and meetings, and may present externally to the state regulator or other external partners.
• Initiates and drafts external-facing print materials and website content about our benefits.
• Needed skills include critical thinking, follow-through, problem-solving, working independently, taking initiative, and working decisively in ambiguity.
  

Required Education

High School diploma.

Required Experience

2 years experience in either customer service, consumer advocacy, project management, or core operations. Experience tracking and reporting on data in Excel and Smartsheet. Basic understanding of managed care. Proficiency with Microsoft Suite programs (i.e. Word, Excel, PowerPoint, Outlook, OneNote, Teams). Proofreading ability.

Required License, Certification, Association

Must have valid driver's license with good driving record and be able to drive within the state of Ohio with reliable transportation.

Preferred Qualifications

• Call center experience.

• Managed care experience.
Associate's or Bachelor's Degree in Business, Social Work, Human Services, Health Care Administration, or related fields.

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