Molina Healthcare

Senior Specialist, Quality Program Management & Performance (Remote)

Molina Healthcare • $85K — $110K *
Long Beach, CA 90802In-Person
Healthcare
Less than 5 years of experience
1 month ago
Job Overview by Ladders

Qualifications

  • Bachelor's Degree or equivalent combination of education and work experience
  • Minimum 3 years of experience in healthcare; at least 2 years in health plan quality improvement or managed care
  • Proven business writing skills
  • Operational knowledge of Excel and Visio for process mapping

Responsibilities

  • Lead project and program activities ensuring compliance with quality program requirements
  • Implement and finalize documentation for quality program management meetings
  • Prepare for quality improvement audits and federal/state quality activities
  • Monitor key quality activities to ensure timely and accurate results
  • Write reports and collaborate with specialists to clarify regulatory specifications
  • Maintain quality program management project plans aligned with regulations
  • Create and manage documentation for critical quality improvement functions

Benefits

  • Comprehensive health insurance plans
  • Generous paid time off and holidays
  • 401(k) with company match
  • Opportunities for professional development and certification
  • Flexible work arrangements
  • Employee wellness programs
Full Job Description
Job Description

Job Description

Job Summary

The Senior Specialist, Quality Program Management and Performance implements new and existing healthcare quality improvement activities to maintain compliance with quality program requirements and reporting and monitoring for key quality program activities. Acts as a lead specialist to provide project, program, and/or initiative related direction. Provides guidance for other specialists within the department and/or collaboratively with other departments to ensure quality programs meet regulatory requirements.

Job Duties
  • Acts as a lead specialist to provide project-, program-, and/or initiative-related direction and guidance for other specialists within the department and/or collaboratively with other departments to ensure quality programs meet regulatory requirements
  • Implements key quality program activities that maintain quality compliance, including maintaining responsibility for preparing and finalizing quality program management committee and other meeting documentation, which capture thorough discussion and participation of attendees, follow-up actions, and next steps, in a clear and understandable way
  • Oversees quality program management activities, which include preparation for quality improvement audits, surveys, and other federal and state-required quality activities
  • Monitors and ensures that key quality activities are completed on time and accurately to present results to key departmental management and other Molina departments, and to formal committees and subcommittees as needed
  • Writes narrative reports and works with departmental specialists (as appropriate) to interpret regulatory specifications, explain programs and results of programs, and document findings
  • Maintains quality program management project plan to ensure state (and/or federal and NCQA-related) requirements are documented during the year
  • Works with the Manager and/or Director to maintain up-to-date addendums to quality policies and procedures that clearly document state-specific activities and requirements in collaboration with the national teams
  • Creates, manages, and/or compiles the required documentation to maintain critical quality improvement functions
  • Leads quality improvement activities, meetings, and discussions with and between other departments within the organization
  • Evaluates project/program activities and results to identify opportunities for improvement
  • Surfaces to the Manager and/or Director any gaps in processes that may require remediation
  • Other tasks, duties, projects, and programs assigned
  • This position may require same-day out-of-office travel, depending upon the location
  • This position may require multiple days' out of town overnight, depending upon location


Job Qualifications

REQUIRED QUALIFICATIONS:
  • Bachelor's Degree or equivalent combination of education and work experience
  • Min. 3 years of experience in healthcare with a minimum of 2 years of experience in health plan quality improvement, managed care, or equivalent experience
  • Demonstrated solid business writing experience
  • Operational knowledge and experience with Excel and Visio (flow chart equivalent)

PREFERRED QUALIFICATIONS:
  • Degree in Preferred field: Clinical Quality, Public Health, or Healthcare
  • 5 years of experience in health plan quality management
  • Experience with data reporting, analysis, and/or interpretation
  • Active, unrestricted Certified Professional in Health Quality (CPHQ)
  • Active, unrestricted Nursing License (RN may be preferred for specific roles)
  • Active, unrestricted Certified HEDIS Compliance Auditor (CHCA)


#PJHS

#LI-AC1

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

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