job

Under the direction of the Chief Operating Officer, the Vice President of Member Experience is responsible for providing senior level leadership, guidance to the Member Services, Transportation Services, and Business Systems & Transformation Teams. The responsibilities include, but are not limited to, department level performance, program/project leadership and performance, and cross-functional projects and outcomes. Provides oversight over all aspects of the Member experience, strategy, and initiatives. Creates and develops strategic alliances and relationships. Serves as an internal advocate and the voice of the Member. The Vice President of Member Experience has responsibility to plan, organize, lead, and coordinate the IEHP approach to achieve high performance in key service-related functions and programs from a Member perspective.

Brings awareness to IEHP Executives and Departments on how their work impacts the Member and drive the strategy and execution of Member experience initiatives across the organization. This position is responsible for defining and executing complex, cross functional solutions that focus on maximizing the Members’ experience by optimizing the Members’ abilities to navigate their benefits. The Vice President, Member Experience will lead change within the organization, with a strong ability to prioritize and operationalize improvements. Develops and executes a robust Member Experience strategy to influence cultural change across the organization and to drive enhanced results.

Duties and Responsibilities: This section is an outline of functions performed on a regular basis, how the position functions within IEHP, and who the tasks are exchanged with.

• Ensure regulatory documentation prepared by the Member Services, Transportation Services, and Business Systems & Transformation teams is accurate and meets regulatory requirements. Participates in audits and interacts with regulatory agencies as a credible, influential, and respected leader.
• Work closely with IEHP’s Vice President, Quality, Vice President, Health Services Clinical Integration & Operations, and Vice President, Provider Experience to prioritize efforts and launch improvement activities based on Member experience surveys (CAHPS), data, HEDIS, and real-time Voice of the Member feedback.
• Meet and communicate regularly with organization-wide operations, non-operations, and clinical leaders to evaluate existing programs, plan, and implement new programs that support identified Member needs.
• Cultivate and maintain positive working relationships at all levels of the organization to ensure positive collaboration to identify, assess, and prioritize upstream and downstream impacts of Member initiatives throughout the organization.
• Lead health plan activities to improve and ensure high performing service is available to IEHP Members.
• Implement new ideas to improve processes, create efficiency through implementation of new technologies (including automation and leading edge AI solutions) or improving those already deployed, ultimately to produce high performing service and quality.
• Identify gaps and systematic opportunities for improvement for the organization and defines and designs efforts that will improve the Member Experience focusing on using Lean principles to improve key operations and operational work systems, under the direction and guidance of the COO.
• Focus on driving IEHP strategies and is directly responsible for leading critical programs and initiatives designed to move the organization’s strategic priorities forward.
• Partner with Executive Leadership team and other key stakeholders to analyze, design, document, and communicate strategic opportunities for improving the Member experience, reducing Member call and grievance drivers, service design, and technology enablers such as omnichannel, Member portal, and Member self-service.
• Leverage global and industry best practices and benchmarks to measure and improve Member Experience functions as well as the Member Experience itself.
• Create a high performing workforce and fostering an environment that supports and promotes best in class performance and a culture that supports IEHP’s MVV.

Experience Requirements:

• A minimum of ten (10) years of experience in a leadership position within the health plan administration function.
• Demonstrated experience in health plan operations, integrated health care delivery system.
• Hands on experience implementing digital transformation projects involving user experience design, engagement, and development of member/provider portal self-service and Voice of the Member capabilities.

Educational Background:

• Master’s degree in a related field from an accredited institution required.
• In lieu of a Master’s degree, a minimum of a Bachelor’s degree and four (4) years of additional relevant work experience is required for this position. This experience is in addition to the minimum years listed in the Experience Requirements above.
• In lieu of a Master’s degree and a Bachelor’s degree, a minimum of twelve (12) years of additional relevant work experience is required for this position. This experience is in addition to the minimum years listed in the Experience Requirements above.

Knowledge:

• Managed care, government programs, or other product lines.
• Healthcare, health plans and/or health plan accreditation principles and practices, in directing operations within the organization.
• Regulatory and compliance requirements related to Medi-Cal, Medicare of Commercial products, including but not limited to the California Knox-Keene Healthcare Service Plan Act and Regulations.
• Demonstrated knowledge of health plan operations.
• Strong experience in Customer Experience/Voice of the Member approaches, NPS scoring, and related technology.

Skills:

• A high level of diplomacy is necessary to anticipate, recognize and deal effectively with sensitive Member issues
• Strong leadership skills required including team development, mentoring, and coaching, and personnel management.
• Strong interpersonal and relationship building skills; ability to develop strategic partnerships both internally and externally.
• Strategic thinker with ability to translate complex operational challenges into practical action plans.
• Ability to demonstrate emotional intelligence skills, thought leadership, and flexibility to handle uncertainties in a changing environment.
• Excellent communication skills; verbal and written.
• Strong organizational skills and attention to detail.

Abilities:

• Work independently and collaboratively within a team environment to deliver results.
• Manage multiple projects with competing deadlines and changing priorities with proven execution against aggressive objectives.
• Partner with external stakeholders to execute goals and initiatives of the organization.
• Ability to drive alignment across executives and peers at all levels in the organization.
• Work in a complex, rapidly evolving environment which requires high-level initiative, and judgment necessary to bring resolution to sensitive issues.
• Communicate effectively to a variety of audiences in small or large group settings.

Commitment to Team Culture:
The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.

Working Conditions:
Position is eligible for Hybrid work location upon completing the necessary steps and receiving HR approval. All IEHP positions approved for telecommute or hybrid work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership.

IEHP Team Members are expected to ensure the privacy and security of PHI (Protected Health Information) as outlined in IEHP’s policies and procedures related to HIPAA compliance.

The position purpose, principal accountabilities, essential functions, minimum qualifications and the requirements listed in this position description are representative only and are not exhaustive of the tasks that a Team Member may be required to perform. IEHP reserves the right to revise this job description at any time, and to require Team Members to perform other tasks as circumstances or conditions of its business considerations or work environment change.

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