About the Role

Are you a seasoned leader with a passion for healthcare technology and system optimization? Molina Healthcare is seeking a visionary Director of Core Systems Strategies to lead our mission-critical configuration initiatives. In this pivotal role, you will be the architect of our QNXT and NetworX infrastructure, ensuring that our claims databases, benefit structures, and contracting frameworks operate with absolute precision and efficiency. This is a unique opportunity to shape the operational backbone of a healthcare leader while working in a fully remote environment from anywhere in the world.

Overview

The Director of Core Systems Strategies is responsible for directing a high-performing configuration team dedicated to the accurate and timely implementation of critical business data. You will serve as the strategic bridge between complex health plan requirements—including federal and state mandates—and the technical execution within our core systems. You will champion process improvements, optimize workflows, and ensure that our technical infrastructure scales to meet the evolving needs of our organization.

Key Responsibilities

Strategic Leadership: Direct the configuration team, fostering a culture of accountability and excellence to meet or exceed performance targets.
Workflow Optimization: Lead the end-to-end planning and management of configuration workflows, identifying bottlenecks and implementing innovative solutions.
Operational Excellence: Continuously evaluate and refine best practices for contracting, benefits, prior authorizations, and fee schedule configurations.
Resource Management: Assess resource requirements, advocate for team needs, and ensure optimal allocation to achieve departmental and organizational goals.
Process Improvement: Drive the implementation of strategic process improvements, leveraging data and system insights to enhance operational efficiency.

Requirements

Extensive experience in healthcare system configuration, with deep expertise in QNXT and NetworX platforms.
Proven track record in a leadership capacity, managing teams within a complex, highly regulated healthcare environment.
Strong understanding of claims databases, provider contracting, and health plan benefit structures.
Demonstrated ability to navigate federal and state compliance requirements.
Exceptional strategic planning, analytical, and problem-solving skills.
Experience in remote team leadership and driving large-scale system implementations.

What You'll Gain

The flexibility of a 100% remote position, allowing you to contribute from anywhere in the world.
A leadership position at a Fortune 500 healthcare company dedicated to providing quality care.
The ability to influence high-level strategy and directly impact the success of core operational systems.
Opportunities for professional growth and collaboration with cross-functional leaders in the healthcare tech space.