Molina Healthcare

Director, HEDIS Performance & Strategy (Enterprise Medicare) - REMOTE

Molina Healthcare$125K — $150K *
US-AnywhereRemote in United States
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Deep expertise in HEDIS specifications and Medicare Star Ratings.
  • Proven track record of leading Medicare quality initiatives in matrixed organizations.
  • Strong analytical skills for interpreting performance data.
  • Excellent communication and relationship management abilities.
  • Lean Six Sigma Black Belt preferred; DSNP experience is a plus.

Responsibilities

  • Lead execution of Medicare HEDIS and Stars strategies through actionable workstreams.
  • Coordinate enterprise readiness for NCQA, CMS, HEDIS, and Stars measure changes.
  • Drive enhancements in operations and documentation aligned with measure requirements.
  • Align various teams around enterprise priorities and accountability.
  • Analyze performance trends and measure gaps to identify improvement opportunities.
  • Identify performance risks and recommend solutions to enhance Stars-aligned measures.
  • Maintain workplans and track progress while driving continuous improvement.

Benefits

  • Comprehensive benefits package including health, dental, and vision coverage.
  • Retirement savings options with company matching contributions.
  • Professional development opportunities to enhance career growth.
  • Work-life balance initiatives to support employee well-being.
Full Job Description
Job Description

Job Description

The Director, HEDIS Performance & Strategy leads the execution of enterprise initiatives to improve HEDIS measures aligned with Medicare Star Ratings. As a strategic partner to senior quality leadership, this role translates priorities into coordinated workstreams across markets and shared services, aligning operations, supplemental data, reporting, provider engagement, and quality improvement.

The ideal candidate brings deep expertise in HEDIS operations, Medicare Stars, supplemental data, and measure implementation, with the ability to analyze performance, influence matrixed stakeholders, and drive accountability.

Primary Responsibilities

Strategic Deployment & Operational Execution
  • Lead enterprise execution of Medicare HEDIS and Stars strategies by translating quality priorities into actionable measure-level workstreams.
  • Coordinate enterprise readiness planning for upcoming NCQA, CMS, HEDIS, and Stars measure changes.
  • Drive implementation of operational, documentation, coding, workflow, and supplemental data enhancements aligned to measure requirements.

Cross-Functional Leadership & Alignment
  • Align Quality, Care Management, Pharmacy, Network, Provider Engagement, Analytics, IT, Supplemental Data, and market stakeholders around enterprise priorities, execution, and accountability.

Measure Performance Optimization
  • Analyze measure gaps, performance trends, supplemental data impact, chase outcomes, and intervention effectiveness to prioritize improvement opportunities.
  • Proactively identify performance risks and operational barriers, recommend remediation, and monitor improvement initiatives for Stars-aligned measures.

Supplemental Data & HEDIS Operations
  • Assess opportunities for evaluation, integration, mapping, validation, and optimization of supplemental data sources in partnership with Systems and technical teams.
  • Ensure documentation workflows and source systems support data integrity, audit readiness, measure capture, and HEDIS reporting accuracy.

Program & Project Management
  • Maintain enterprise workplans, timelines, risks, dependencies, decisions, and progress reporting while driving stakeholder accountability and continuous improvement.

Executive Support & Communication
  • Develop executive materials, performance analyses, prioritization recommendations, and implementation updates for leadership and governance forums.


Required Qualifications
  • Deep expertise in HEDIS specifications, Medicare Star Ratings, supplemental data, and enterprise quality operations.
  • Demonstrated success leading complex, cross-functional Medicare quality initiatives and operational workstreams in matrixed organizations.
  • Strong analytical skills with experience interpreting performance data and operational impacts.
  • Excellent relationship management and communication skills.
  • Lean Six Sigma Black Belt preferred certification.
  • DSNP experience preferred.


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.

About Molina Healthcare

Molina Healthcare focuses exclusively on government-sponsored health care programs for families and individuals who qualify for government-sponsored health care. It contracts with state governments and serves as a health plan, providing a wide range of quality health care services to families and individuals.

Molina Healthcare Careers

Join the dedicated team at Molina Healthcare, a leader in providing quality healthcare services to families and individuals who qualify for government-sponsored programs, including Medicaid and Medicare. As one of the most respected companies in the health services industry, Molina Healthcare offers unparalleled job opportunities aimed at empowering your career growth and professional development.

Work You’ll Do

At Molina Healthcare, you will engage in meaningful work that directly impacts lives across the country. Our team is committed to innovation in healthcare, ensuring that all members receive the best care possible. By joining us, you will collaborate with skilled professionals dedicated to our mission of providing accessible, high-quality healthcare.

Career Opportunities and Growth

Whether you are looking for your first job, seeking a leadership role, or aiming to specialize in healthcare professions, Molina Healthcare offers a range of career paths. Our job opportunities span across various functions, including clinical services, customer support, IT, project management, and more. We believe in fostering the growth of our employees through professional development, leadership training, and diversity initiatives.

Internship Programs

Kickstart your career with a Molina Healthcare internship. Our internships provide invaluable workplace experience, offering a glimpse into the healthcare industry through hands-on projects and mentorship. Interns at Molina Healthcare gain critical skills that prepare them for future employment, making them competitive candidates in the job market.

Culture and Benefits

Molina Healthcare is not just a company; it’s a community. We prioritize a culture of inclusivity and respect, where all team members are encouraged to bring their whole selves to work. Our employees enjoy comprehensive benefits, including health insurance, retirement plans, and wellness programs, all designed to support both their professional and personal lives.

Join Our Team

Explore the various positions available at Molina Healthcare and find where your skills and interests align with our needs. We are continuously hiring talented individuals who are passionate about making a difference in healthcare. Prepare your resume, sharpen your interview skills, and become part of a team that values hard work and creativity.

Stay Connected

Keep up to date with the latest at Molina Healthcare: - **Career Growth and Networking:** Advance your career through our professional development and networking opportunities. Learn from leaders and peers alike to build connections that propel your career forward. - **Innovation and Leadership:** Drive change and lead with confidence by participating in our leadership and innovation training programs.

Apply Now

Ready to take the next step in your healthcare career? Search open positions that match your skills and interests on the Molina Healthcare Jobs portal. We look for driven, curious, and compassionate team players ready to make an impact.

Stay Informed

Subscribe to Molina Healthcare job alerts and receive updates on new openings and company news directly to your inbox. Tailor your subscription to match your career preferences and stay ahead in the dynamic field of healthcare. Join Molina Healthcare, where your career is nurtured, your contributions are valued, and your growth is guaranteed.
Learn more about Molina Healthcare
Size
14,000 employees
Market Cap
$19.5 billion
Industry
Net Income
$673 million
Founded
1980
5 Year Trend
+9.3%
Revenue
$19.4 billion
NASDAQ

Similar Jobs

More Jobs at Molina Healthcare

More Healthcare Jobs

Find similar Director, HEDIS Performance & Strategy (Enterprise Medicare) - REMOTE jobs: