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Job Description

Job Summary

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.

Job Duties

+ 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 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 higher complexity quality program management activities, which include 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 to present results to key departmental management and other Molina departments, and to formal committees and subcommittees as needed

+ Prepares 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

+ Engages in problem solving and remediation of any escalations or gaps at the direction of the with 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.

Job Qualifications

REQUIRED 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)

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

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

Pay Range: $66,456 - $129,590 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.