Executive Lead, Health Plan Operations

Molina Healthcare; Omaha (NE); On-site; USD 162,000 - 316,000; Full time

Job summary

Molina Healthcare seeks an experienced executive to lead state health plan operations in Nebraska. You will provide strategic direction for Medicaid/CHIP, Medicare and Marketplace programs, ensuring contract compliance, program performance, and member satisfaction in a complex, matrixed environment.

As the senior plan leader, you will oversee claims, enrollment, configuration management, support center operations, and collaboration with corporate operations to drive improvements and manage risks

Qualifications

• 12+ years in health care operations, administration, and/or provider services.
• 7+ years of management/leadership experience.
• Deep experience with Medicare, Medicaid, and Marketplace plans.
• Experience with prompt pay laws.
• Claims-related experience.
• Strong ability to manage multiple projects and deadlines.
• Excellent verbal and written communication skills.
• Proficiency with Microsoft Office and related software.

Responsibilities

• Support executive strategy development and monitor performance against goals.
• Direct and coordinate state health plan operations under leadership.
• Ensure compliance with contracts and regulatory requirements, and meet SLAs.
• Plan and oversee Medicaid/CHIP, Medicare and Marketplace operations.
• Collaborate with staff and senior leadership to improve non-clinical ops.
• Liaise with enrollment, claims, configuration management, and support centers.

Skills

Verbal comms

Written comms

Time management

Cross-functional collab

Tools

Excel

Job description

Molina Healthcare seeks an experienced executive to lead state health plan operations in Nebraska. You will provide strategic direction for Medicaid/CHIP, Medicare and Marketplace programs, ensuring contract compliance, program performance, and member satisfaction in a complex, matrixed environment.

As the senior plan leader, you will oversee claims, enrollment, configuration management, support center operations, and collaboration with corporate operations to drive improvements and manage risks