About this role.
The Director, Member Experience (Process Improvement) at Molina Healthcare is a remote leadership role focused on developing and executing enterprise-wide strategies to improve Medicaid membership retention and satisfaction. This role requires a seasoned professional with deep Medicaid Managed Care experience, process improvement expertise (Six Sigma), and strong cross-functional collaboration skills. The director will drive process improvements across pharmacy, provider relations, and other critical areas, while overseeing performance metrics and working closely with senior leadership. Healthcare/pharmacy experience is highly preferred, and the ideal candidate thrives in a fast-paced, autonomous environment.
Role DNA
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Job Complexity
4/5Pace & Pressure
4/5Autonomy Level
5/5Communication Load
5/5Salary analysis
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Core skills
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Cover letter sample
Dear Hiring Manager,
I am writing to express my interest in the Director, Member Experience position at Molina Healthcare. With over 7 years of experience in Medicaid Managed Care and a proven record of leading process improvement initiatives, I am excited to contribute to your mission of enhancing member retention and satisfaction.
My background includes driving cross-functional strategies, implementing Six Sigma methodologies, and collaborating with senior leadership to achieve organizational goals. I am particularly drawn to Molina's commitment to member-centric solutions and would welcome the opportunity to bring my expertise to your team.
Thank you for considering my application. I look forward to discussing how I can support your enterprise-wide membership goals.
Sincerely, [Your Name]
Sample interview questions
In my previous role, I led a cross-functional team to analyze member churn data in our Medicaid expansion population. We identified key pain points in the pharmacy authorization process and redesigned the workflow, reducing turnaround time by 30%. This improvement contributed to a 5% increase in member retention within a year. I ensured alignment with state regulations and engaged frontline staff in the redesign to ensure buy-in.
I would start by conducting a comprehensive analysis of member feedback, operational metrics, and state-specific requirements. Then I would segment the member base by LOB and prioritize initiatives based on impact and feasibility. I would establish clear scorecards with monthly targets and work closely with health plan leaders to adjust strategies as needed. Regular communication with state partners and internal stakeholders would be essential to ensure alignment.
I am a certified Six Sigma Black Belt. I have led many DMAIC projects, focusing on reducing defects in claims processing and improving member onboarding. For example, I used root cause analysis to identify bottlenecks in eligibility verification, which allowed us to streamline the process and reduce errors by 40%. I also train team members on Lean principles to foster a culture of continuous improvement.
I believe in understanding the concerns behind resistance. I would engage stakeholders early, present data-driven evidence and highlight quick wins. By involving them in the design process and showing how the change benefits their objectives, I can build consensus. For instance, when introducing a new member outreach protocol, I worked with the provider relations team to address their capacity concerns, and we co-created a schedule that minimized disruption.
I would use a combination of leading and lagging indicators, such as member satisfaction scores (e.g., CAHPS), retention rates, complaints per thousand members, and net promoter score. I would also track process-specific metrics like response times to service requests and resolution rates. Regular scorecard reviews with the leadership team would help ensure we are on track.
Job Summary
The Director, Member Experience is responsible for developing, implementing, and monitoring a successful strategy to achieve Molina’s Medicaid membership retention goals & objectives across the enterprise for the Medicaid lines of business (TANF, ABD, Expansion, CHIP) including similar solutions for other LOBs (Medicare, Marketplace) as appropriate. This position is accountable for the development of enterprise strategies that lead to membership growth and retention.
The ideal candidate would be curious, enjoy cross functional collaboration, and have a proven track record of creating and implementing successful strategies to improve member/customer satisfaction. This role will be full-time remote and healthcare/pharmacy experience is highly preferred.
Knowledge/Skills/Abilities
- Identify and drive process improvements to enhance the member and provider experience.
- Develop strategies to alleviate pain points in areas such as pharmacy, network and provider relations, pharmacy, and other critical areas the effect overall experience.
- Participates and contributes in Enterprise Health Plan meetings, regarding the overall strategic planning for the health plan.
- Identifies opportunities and helps develop / prioritize initiatives that help with member retention.
- Works closely with the leadership team to ensure that the results of member satisfaction/retention activities are consistent with the state’s direction and objectives, and develops & implements strategies to quickly course correct, when necessary.
- Establishes and reviews performance metrics (“scorecards” and reports) on a regular basis to ensure each health plan is on track to deliver results in line with the organizations strategic plan; provides recognition and recommendation to improve performance.
- Communicates extensively with other Molina departments to ensure policies, programs and strategies achieve membership retention targets.
- Identifies technology support needs that help facilitate member retention and satisfaction activities and drives successful implementation.
Job Qualifications
REQUIRED EDUCATION:
Bachelor’s degree in health-related degree or equivalent experience.
REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:
- Minimum 7 years’ experience in Medicaid Managed Care, particularly in sales or outreach role.
- Minimum 3 years management/supervisory experience.
- Exceptional networking and negotiations skills, as well as strong public speaking/presentations skills.
- Ability to work in a fast-paced, team-oriented environment with little supervision.
- Process Improvement (Six Sigma) expertise.
- Proven ability to influence or persuade senior level leaders regarding matters of organizational significance.
- Proven ability to influence policy making.
- Knowledge of applicable State, Federal and third-party regulations.
- Thorough understanding of Medicaid product lines.
- Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.
PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:
Active State Life and Health and/or Disability License without infraction.
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
Annual salary information is not provided for this position. Explore salary ranges for similar roles in our Salary Directory ›
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