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Director, Health Plan Quality Program Management & Performance (Remote in New York)
Molina Healthcare
New York City, USA
Full-time
Director · 8+ years experience
Onsite
Discovered 1 weeks ago
Role Overview
Leads and directs team responsible for quality management and quality performance improvement activities. Responsible for overseeing, planning, and implementing new and existing health plan quality improvement activities to maintain compliance with quality program requirements and reporting and monitoring for key quality program activities, and provides support and implementation of National Committee for Quality Assurance (NCQA) accreditation surveys and federal/state quality improvement compliance activities, including compliance with Healthcare Effectiveness Data and Information Set (HEDIS) regulations.
Full Job Posting
Required Qualifications
- At least 8 years of experience in health care, with at least 5 years of experience in health plan quality improvement, or equivalent combination of relevant education and experience. • At least 3 years management/leadership experience.
- Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. • Advanced knowledge and understanding of HEDIS/NCQA. • Consumer Assessment of Healthcare Providers and Systems (CAHPS) improvement experience. • Healthcare Effectiveness Data and Information Set (HEDIS) reporting/collection experience. • Experience with government-sponsored programs (Medicaid, Medicare, Marketplace). • State quality improvement (QI) experience. • Solid business writing experience. • Strong strategic-thinking skills. • Strong proficiency with data analysis, manipulation, interpretation, reporting and data-driven decision-making. • Critical-thinking, problem-solving and analytical skills. • Attention to detail and organizational skills. • Ability to implement process improvement initiatives and drive change. • Ability to work independently in a fast-paced, deadline-driven environment. • Ability to work in a cross-functional highly matrixed organization. • Project management experience. • Excellent verbal and written communication skills. • Microsoft Office suite (including Excel), and applicable software programs proficiency, and ability to learn new information systems and software programs.
- At least 8 years of experience in health care, with at least 5 years of experience in health plan quality improvement, or equivalent combination of relevant education and experience.
- At least 3 years management/leadership experience.
- Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates.
- Advanced knowledge and understanding of HEDIS/NCQA.
- Consumer Assessment of Healthcare Providers and Systems (CAHPS) improvement experience.
- Healthcare Effectiveness Data and Information Set (HEDIS) reporting/collection experience.
- Experience with government-sponsored programs (Medicaid, Medicare, Marketplace).
- State quality improvement (QI) experience.
- Solid business writing experience.
- Strong strategic-thinking skills.
- Strong proficiency with data analysis, manipulation, interpretation, reporting and data-driven decision-making.
- Critical-thinking, problem-solving and analytical skills.
- Attention to detail and organizational skills.
- Ability to implement process improvement initiatives and drive change.
- Ability to work independently in a fast-paced, deadline-driven environment.
- Ability to work in a cross-functional highly matrixed organization.
- Project management experience.
- Excellent verbal and written communication skills.
- Microsoft Office suite (including Excel), and applicable software programs proficiency, and ability to learn new information systems and software programs.
Preferred Qualifications
- Demonstrated experience in leading significant cross-functional work. • Provider credentialing and subcontractor monitoring experience. • Certified Professional in Health Quality (CPHQ). • Certified HEDIS Compliance Auditor (CHCA). • Registered Nurse (RN). If licensed, license must be active and unrestricted in state of practice.
- 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. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
- Demonstrated experience in leading significant cross-functional work.
- Provider credentialing and subcontractor monitoring experience.
- Certified Professional in Health Quality (CPHQ).
- Certified HEDIS Compliance Auditor (CHCA).
- Registered Nurse (RN). If licensed, license must be active and unrestricted in state of practice.
- 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. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
About Molina Healthcare
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