Job Details

Director Of Ctm Oversight & Resolution

Safeguard member trust and plan compliance by owning Molina's entire CMS Complaints Tracking Module (CTM) life cycle. As Director of CTM Oversight & Resolution you set the standards and controls that internal teams and delegated vendors must follow,and you keep complaint data synchronized across appeals & grievances, enrollment, claims, pharmacy, and quality functions. You surface systemic issues, steer partners toward durable fixes, and convert disciplined CTM management into Stars gains, audit readiness, and measurable member-experience improvements. You'll begin as a senior individual contributor with the charter to build a focused CTM resolution team as demand grows.

Knowledge, Skills & Abilities

• CTM Intake & Triage Expertise
• Resolution Quality & Compliance Mastery
• Partner & Vendor Governance
• Continuous Improvement & Strategic Leadership

Core Duties

• Case Audits
• Workflow Integration
• Capabilities Roadmap
• Vendor Performance Validation
• Innovation & Enablement
• Other Responsibilities

Qualifications

• Education: Bachelor's degree - Health Administration, Business, Information Systems, or related field (advanced degree a plus).
• Experience: 7+ years managing Medicare CTM, appeals & grievances, or related compliance functionshands-on with CMS CTM portal, SLA tracking, and program audits.
• Skills & Competencies: Mastery of CMS CTM guidelines, escalation protocols, and compliance frameworks. Sharp analytical and root-cause skills; comfortable with Excel, SQL/BI, or similar toolsets for complaint trending. Persuasive communicator and consensus-builder across health-plan stakeholders and external partners. Demonstrated ability to translate regulatory change into road-mapped system and workflow upgrades.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $88,453 - $172,981 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.