Molina Healthcare

Manager, Quality Program Management & Performance (Remote in NV)

Molina Healthcare$80K — $120K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's Degree or equivalent education and work experience
  • 5-7 years of healthcare experience with 2 years in health plan quality management
  • Strong business writing skills
  • Operational experience with Excel and Visio

Responsibilities

  • Lead compliance activities with state and federal quality requirements
  • Manage quality program activities and staff oversight
  • Maintain quality program management structures and policies
  • Prepare detailed reports of quality program activities and incorporate feedback
  • Revise policies reflecting state and federal quality requirements
  • Train quality program staff on regulatory compliance
  • Track quality program requirements and key performance indicators
  • Apply quality improvement methodologies like PDSA for process enhancements

Benefits

  • Competitive benefits package
  • Opportunities for training and development
  • Supportive workplace culture
  • Potential for travel opportunities
Full Job Description
Job Description

Job Description

Job Summary

The Manager, Quality Program Management and Performance oversees and leads activities to maintain compliance with state requirements and federal and/or NCQA quality requirements, as appropriate in collaboration with quality leadership. Manages quality program management activities to ensure compliance with regulatory requirements, including managing staff.

Job Duties
  • Oversees and leads activities to maintain compliance with state requirements and federal and/or NCQA quality requirements, as appropriate in collaboration with quality leadership with implementation of Health Plan quality program management and performance activities
  • Manages quality program management activities to ensure compliance with regulatory requirements, including managing staff
  • Maintains structure and processes for quality program management, including maintenance and modification of quality policies and procedures, management and oversight of committee and workgroup structure and document management, report completion to meet requirements, and tracking of key deliverables
  • Prepares written reports and documents that clearly outline the quality program activities and ensure that member and provider feedback is incorporated into quality program management meetings, outcomes from these activities are documented, and continuous quality improvement tools are used to highlight the processes, interventions, and remeasurements are conducted to meet improvement goals
  • Maintains ongoing revision of policies and procedures reflective of state requirements (and/or federal and NCQA requirements, as appropriate) for all quality program management functions by overseeing the ongoing incorporation and modification of requirements into state-specific policy addendums
  • Manages training and education of quality program management and performance staff about completion of quality program management and performance activities in line with regulatory requirements
  • Ensures all quality program management and performance staff are well-versed in the requirements of the quality program and day-to-day work processes to support compliance with state contracts, policies and procedures, and program requirements
  • Implements tracking and trending of quality program requirements on an ongoing basis, including operational key performance indicators, process reviews, and gap analyses
  • Utilizes proven quality improvement methods, such as the Plan-Do-Study-Act (PDSA) cycle, to facilitate individual, team, and organizational process improvement
  • Demonstrates flexibility when it comes to changes and maintains a positive outlook
  • Has excellent conflict resolution problem-solving skills
  • This position may require same-day out-of-office travel 0 - 50% of the time, depending on the location
  • This position may require multiple days out of town overnight travel 0 - 20% of the time, depending upon location


Job Qualifications

REQUIRED QUALIFICATIONS:
  • Bachelor's Degree or equivalent combination of education and work experience
  • 5-7 years of experience in healthcare with a minimum of 2 years' experience in health plan quality management improvement, managed care, or equivalent experience
  • Demonstrated solid business writing experience
  • Operational knowledge and experience with Excel and Visio (flow chart equivalent)

PREFERRED QUALIFICATIONS:
  • Advanced degree in Nursing, Public Health, Health Administration, Social Work, or related field
  • HEDIS reporting or collection
  • CAHPS improvement experience
  • State QI experience
  • Medicaid experience
  • Supervisory experience
  • Project management and team building experience
  • Certified Professional in Health Quality (CPHQ)
  • Nursing License (RN may be preferred for specific roles)
  • Certified HEDIS Compliance Auditor (CHCA)


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 Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

#PJCorp

#LI-AC1

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

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