Marketplace Ops Mgr

Job Description 
 

Job Summary

The Marketplace Operations Manager plays a key role in the oversight and strategic development of the Marketplace operations. Responsible for providing subject matter expertise for an array of Marketplace activities and overseeing key member experience and operational excellence initiatives. Enhances the efficiency and functionality of Marketplace Operations to ensure program success.

 

Knowledge/Skills/Abilities

 

• Develop and implement strategic initiatives to achieve company growth objectives in the Individual and Family Plans (IFP) market, with a particular focus on the Health Insurance Marketplace (Exchange).
• Conduct thorough analysis of the Affordable Care Act (ACA) and its impact on the IFP market, including regulatory updates, subsidies, and market trends.
• Lead the development and execution of go-to-market strategies for the Exchange, including product development, pricing strategy, and marketing campaigns.
• Oversee competitor analysis and identify opportunities to differentiate Molina Healthcare Inc. in the Exchange market.Collaborate with internal stakeholders across departments (Product, Marketing, Sales, Actuarial, Provider Network) to ensure alignment and successful execution of strategic initiatives.
• Develop and maintain strong relationships with both Marketplace Segment and Health Plan leaders andServes as a Subject Matter Expert (SME) for Marketplace operational activities, including omni-channel, marketing, communications, print & fulfillment, sales, distribution, retention, and enrollment.
• Under the direction of Marketplace leadership, oversees and coordinates operational systems, processes, and infrastructure in collaboration with Health Plans and Health Plan Services.
• Acts as liaison with Health Plan services and Health Plans; monitors performance metrics to ensure optimal performance while identifying opportunities for process improvement and execution.
• Anticipates and tracks operational and tactical risks; implements strategies and tactics in partnership with Health Plan Services to mitigate any issues or performance not meeting established service levels; enforces accountability and escalates to leadership as required.  
• Provides oversight of new projects and initiatives and drives relationship with vendors and external partners to ensure project milestones are met
• Supports transparency to the Marketplace segment, ensuring appropriate awareness and operational readiness for program and/or operational changes.
• Supports health plans with product and message management; develops and oversees content for all segment related materials, ensuring regulatory compliance and alignment with Molina brand.
• Collaborates with cross-functional partners to ensure all operational, administrative, and compliance functions within the Marketplace segment are properly executed in accordance to regulatory requirements and segment best practices.
• Develops business case and implementation plans for new programs, ensuring regulatory and business milestones are met. Leads product implementations from start to finish, to include oversight of command center and user acceptance testing; identifies and executes solutions to overcome any barriers
• Stays up to date on industry regulations, trends, and technology.
• May work on other special planning and segment projects, as assigned.

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  Job Qualifications REQUIRED EDUCATION: Bachelor’s degree in program management, healthcare administration, business or public administration, technical management, or related fields REQUIRED EXPERIENCE:

• 8+ years of experience with minimum of four (4) years of recent overall project/Ops management experience
• Ability to address operational concerns and issues, monitoring overall customer satisfaction
• Ability to develop and implement operational procedures and policies
• Excellent interpersonal communication and organizing skills to coordinate project activities
• Ability to communicate with others effectively
• Ability to conduct research for special projects, respond timely inquiries, and presentations
• Ability to work with details and time-sensitive issues
• Good decision-making skills and response to high-pressure situations

 

PREFERRED EDUCATION:

 Master’s of Business Administration (MBA)

PREFERRED EXPERIENCE:

Experience in MS Project, Visio, Jira, etc. preferred.

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

A Project Management Professional (PMP) certified by the Project Management Institute (PMI) can be used in lieu of the education