Director, Medicare Segment Optimization (D-SNP Market ...

**Job Description** **Job Summary** Drives and directs the overall performance of assigned D-SNP markets. Serves as the D-SNP market lead responsible for individual market P&L performance in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state, and local regulatory requirements. **Job Duties** + Enable market P&L success through support and oversight for assigned markets, including D-SNP market performance management. + Function as Medicare subject matter expert and point of contact for assigned market. + Monitor and support sales and retention efforts. + Monitor compliance and regulatory risks. + Contribute to and present in market performance review meetings. + Collaborate with Network teams on value-based services. + Partner with Government Contracts on regulatory items + Under the leadership of the VP Medicare Segment Lead, this role will facilitate transparent and compliant execution of Medicare performance objectives. + Coordinates accountabilities between segment and markets to drive performance in network, risk adjustment, and stars; single point of contact for escalations from aligned market segments. + Coordinates accountabilities between segment, health plans, and shared services to drive compliance and performance objectives as well as provide oversight, including service level agreements. + Works with staff and senior management to mitigate risk and develop/implement improvements across areas that impact Medicare performance. + Collaborate across Medicare segment, with health plans, and enterprise shared services to ensure appropriate performance objectives are met; develop leading indicators and alerts for all key operational metrics. + Analyzes activities and identifies trends and potential opportunities within the Medicare segment to achieve performance objectives at a state and overall level. + Develop ownership and outcome recommendation for processes that cross functions - segment, enterprise operations, etc. + Support Health Plan Scorable Action Items (SAIs) to ensure performance and quality levels exist in line with Centers for Medicare & Medicaid Services (CMS) and State regulatory requirements. + Direct implementation, monitoring, and measurement of strategic and tactical plans that contribute to segment and health plan growth and achievement of other performance objectives. + Other operational duties as assigned by the Segment Lead. **Job Qualifications** **REQUIRED QUALIFICATIONS:** + At least 10 years' experience in Managed Care, specifically government programs and/or Medicare/Duals Health Plan Operations, or equivalent combination of education and experience + Strong leadership in a matrixed environment + Demonstrated adaptability and flexibility to a rapidly moving business environment. + Background analyzing technical performance and driving teams to improvement via direct management and oversight + Strong proficiency in MS Office Tools, particularly PowerPoint and Excel. **PREFERRED QUALIFICATIONS:** + Experience with SNP and MMP Plans. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $107,028 - $250,446 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Created: 2025-10-05