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Role Description

The Quality Program Management and Performance Manager develops and 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 subject matter expert providing direction for project, program, and/or initiative related initiatives.
• Provides guidance within the department and/or collaboratively with other departments to ensure quality programs meet regulatory requirements.
• Drives quality program management activities to ensure compliance with regulatory requirements.
• Acts as a subject matter expert and lead specialist to provide project-, program-, and/or initiative-related direction and guidance for other specialists.
• Implements key quality program activities that maintain quality compliance.
• Oversees higher complexity quality program management activities, including preparation for quality improvement reports, audits, surveys, and other federal and state-required quality activities.
• Monitors and ensures that key quality activities are completed on time and accurately.
• Prepares narrative reports and works with departmental specialists to interpret regulatory specifications.
• 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.
• 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.
• Engages in problem solving and remediation of any escalations or gaps at the direction of the Manager and/or Director.
• Other tasks, duties, projects, and programs as assigned.
• This position may require same-day out-of-office travel approximately 0 - 50% of the time, depending upon the location.
• This position may require multiple days out of town overnight travel approximately 0 - 20% of the time, depending upon location.

Qualifications

• Bachelor's Degree or equivalent combination of education and work experience.
• Min. 5 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).

Requirements

• 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.

Benefits

Molina Healthcare offers a competitive benefits and compensation package.

Company Description

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