job

About the Organization:
With a mission to heal and inspire the human spirit, Inland Empire Health Plan (IEHP) is one of the top 10 largest Medicaid health plans and the largest not-for-profit Medicare-Medicaid plan in the country. In its 29th year, IEHP supports nearly 1.6 million members who are enrolled in Medicaid and has a growing network of over 8,000 providers and nearly 4,000 Team Members (Employees). Through dynamic partnerships, award-winning service, and a tradition of quality care, IEHP is fully committed to its Mission, Vision, and Values.

IEHP has consistently achieved outstanding employee engagement scores from their 4,000+ Team Members and was most recently recognized and awarded the designation of ‘Great Place to Work’ for a third year in a row! For details regarding IEHP, please visit: iehp.org.

About the Position:
Under the direction of the Chief Operating Officer, the Vice President, 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. The VP provides oversight over all aspects of the Member experience, strategy, and initiatives. The Vice President creates and develops strategic alliances and relationships, as well as serves as an internal advocate and the voice of the Member. They will have 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.

The Vice President brings awareness to IEHP executives and departments on how their work impacts the Member and drives 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. They will also lead change within the organization, with a strong ability to prioritize and operationalize improvements. The Vice President develops and executes a robust Member Experience strategy to influence cultural change across the organization and to drive enhanced results.

Responsibilities:

– Develop the vision, strategy, and capabilities to deliver best-in-class Member experiences throughout the organization for all products (Medi-Cal, Medicare, and Commercial) and interactions. Foster a service-oriented work environment with an emphasis on dedication to serving Members.
– Provide direct leadership, oversight, and accountability for the effectiveness of the Member Services, Transportation Services, and Business Systems & Transformation teams through the development of an annual workplan that aligns with the organizational priorities which includes key infrastructure projects, training & development plans, and actions focused on continuous improvement of the team’s culture and engagement.
– Establish assessment processes and procedures for the departmental infrastructure and staff to ensure quality of work meets expectations. Drive engagement within the Member Services, Transportation Services, and Business Systems & Transformation leaders to build strong and clear interrelationships to ensure successful operational performance resulting in high levels of Member satisfaction.
– Focus on optimizing the workflows of Member Services and Transportation Services departments by utilizing process automation and Conversational Artificial Intelligence.
– Identify areas of improvement and leads projects and continuous improvement initiatives for the Member Services, Transportation Services, and Business Systems & Transformation teams. Anticipate operational challenges and proactively identify and execute solutions to mitigate obstacles.
– Monitor performance, remove barriers, develop and implement strategies to enhance Member satisfaction in coordination with IEHP’s organization-wide operations, non-operations, and clinical teams.
– Monitor developments on the federal and state level that may impact the Member Services, Transportation Services, and Business Systems & Transformation teams. Develop appropriate strategies as necessary and implement corrective actions as appropriate.
– Ensure regulatory documentation prepared by the Member Services, Transportation Services, and Business Systems & Transformation teams is accurate and meets regulatory requirements. Participate in audits and interact with regulatory agencies as a credible, influential, and respected leader.

The ideal candidate will bring extensive experience in health plan operations and a proven track record of executing complex strategic initiatives. Preferably, the VP will possess expertise across Medi-Cal, Medicare, and Commercial product lines, along with a strong understanding of the Voice of the Member and employing AI to transform the member experience.

This individual must demonstrate a collaborative and inclusive leadership style, with the ability to engage effectively with team members at all levels and partner cross-functionally throughout the organization. A results-oriented mindset, combined with the ability to establish strong working relationships and foster a culture of accountability are essential to the success of this role.

Staff: Direct reports include Senior Director of Member Services, Director of Transportation, Director of Business Transformation; total staff of 768.

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 Requirements:

– 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.

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