Molina Healthcare

Senior National Quality Performance Manager (Remote)

Molina Healthcare • $100K — $120K *
US-AnywhereRemote in United States
Healthcare
Less than 5 years of experience
Today
Be an Early Applicant
Job Overview by Ladders

Qualifications

  • 4+ years of program/project management experience in quality, specifically HEDIS support.
  • Health care experience with knowledge in functional quality.
  • Familiarity with Microsoft Azure or SQL server for running queries.
  • Strong abilities in data analysis, reporting and interpretation.
  • Effective communication skills, both written and verbal.
  • Critical thinking and problem-solving skills with high attention to detail.
  • Experience working in a collaborative, matrixed organization.

Responsibilities

  • Collaborate with health plan quality leaders to enhance outcomes through data-driven strategies.
  • Deliver quality programs on time and within resource constraints.
  • Optimize the completeness and accuracy of quality data ingestion strategies.
  • Identify and resolve complex quality issues through data analysis and collaboration.
  • Lead execution of quality assignments and provide program updates to leadership.
  • Recommend performance improvement initiatives based on quality data analytics.
  • Ensure compliance with quality regulatory guidelines and improve HEDIS audit success.

Benefits

  • Comprehensive health and wellness plans.
  • Flexible work arrangements.
  • Opportunities for professional development and certification support.
  • Employee assistance programs for mental health and well-being support.
Full Job Description
Job Description

JOB DESCRIPTION Job Summary
Provides senior level consultant level support for Molina's quality performance solutions team. Collaborates with various departments and stakeholders across the enterprise to plan, coordinate, and manage resources, and execute quality performance improvement initiatives in alignment with strategic objectives.

Essential Job Duties
  • Collaborates with health plan quality leaders to improve outcomes by leading quality data collection strategy, analytics, and reporting for the following: quality rate trending and forecasting, provider quality measurement performance, Consumer Assessment of Healthcare Providers and Systems (CAHPS) and survey analytics, health equity and social determinants of health (SDOH), and external vendor engagement.
  • Ensures quality programs are successfully delivered on time, within scope, and within resource constraints.
  • Oversees quality data ingestion activities and strategies to optimize completeness and accuracy of electronic health record (EHR)/health information exchange (HIE) and supplemental data impact.
  • Independently identifies, analyzes, and resolves complex quality issues using data analysis, project management skills, and cross-functional collaboration.
  • Leads execution of complex quality assignments, supports program changes, ensures alignment with program goals, and updates leadership and applicable parties on program/project development.
  • Draws actionable quality-related conclusions and recommends performance improvement initiatives.
  • Ensures compliance with all quality-related regulatory audit guidelines by adhering to roadmap of deliverables and timelines, and implements solutions to maximize national Healthcare Effectiveness Data and Information Set (HEDIS) audit success.
  • Partners with cross-functional teams to ensure data quality delivery through sequential transformations, draws actionable conclusions, and identifies opportunities to close quality care gaps.
  • Ensures that program deliverables meet all quality standards and regulatory requirements.
  • Creates and reviews quality-related program documentation, including plans, reports, and records, ensuring deliverables meet quality standards and regulatory requirements.
  • Proactively communicates risks, issues, and progress to stakeholders and escalates unresolved or high-impact concerns to leadership as appropriate.
  • Meets customer expectations and requirements, establishes, and maintains effective relationships and gains trust and respect.
  • Provides advanced subject matter support within the quality team; maintains flexibility to pivot and support other requests as needed.
  • Provides informal guidance and knowledge sharing to team members related to assigned quality initiatives and processes.

Required Qualifications
  • At least 4 years of program/project management experience in quality, including experience supporting HEDIS activities targeting and reporting, or equivalent combination of relevant education and experience.
  • Health care experience and functional quality knowledge.
  • Familiarity with running queries in Microsoft Azure or Structured Query Language (SQL) server.
  • Intellectual agility and ability to simplify and clearly communicate complex concepts.
  • Proficiency with data analysis, manipulation, interpretation, and reporting.
  • Strong quantitative aptitude, critical-thinking, problem-solving, and analytical skills.
  • Attention to detail and organizational skills.
  • Ability to work cross-collaboratively in a highly matrixed organization.
  • Effective verbal, written and presentation communication skills.
  • Microsoft Office suite (including Excel) and applicable software programs proficiency, and ability to learn/navigate new software programs.

Preferred Qualifications
  • Intermediate knowledge/experience related to National Committee for Quality Assurance (NCQA), Healthcare Effectiveness Data Information Set (HEDIS), Centers for Medicare and Medicaid Services (CMS), and state-specific regulatory submission requirements.
  • Microsoft Azure Databricks and SQL proficiency.
  • Knowledge of health care claim elements: Current Procedural Terminology (CPT), CPT Category II (CPTII), Logical Observation Identifiers Names and Codes (LOINC), Systematized Nomenclature of Medicine - Clinical Terms (SNOMED), Healthcare Common Procedure Coding System (HCPS), National Drug Code (NDC), CVX Codes (CVX), National Provider Identifiers (NPIs), Taxpayer Identification Numbers (TINs), etc.
  • Experience working in a cross-functional, highly matrixed organization, preferably within a managed care organization supporting Medicaid, Medicare, and/or Marketplace programs.
  • Project Management Professional (PMP).
  • Six Sigma Green Belt or Black Belt certification, and/or comparable coursework.


To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

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
Healthcare
Net Income
$673 million
Founded
1980
5 Year Trend
+9.3%
Revenue
$19.4 billion
NASDAQ
MOH
* Ladders Estimates

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