Remote opportunity at
Molina HealthcareNational Quality Performance Manager - HEDIS
Molina Healthcare is currently seeking a National Quality Performance Manager - HEDIS for a remote, full-time position. This role functions within the quality performance solutions team…
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About This Role
Molina Healthcare is currently seeking a National Quality Performance Manager - HEDIS for a remote, full-time position. This role functions within the quality performance solutions team to provide subject matter expertise, collaborate with internal departments, and manage resources to execute quality performance improvement initiatives. The position involves working alongside health plan quality leaders to oversee quality data collection strategies, analytics, reporting, and external vendor engagement. Responsibilities include tracking quality rates,…
Job Description
Molina Healthcare is currently seeking a National Quality Performance Manager - HEDIS for a remote, full-time position. This role functions within the quality performance solutions team to provide subject matter expertise, collaborate with internal departments, and manage resources to execute quality performance improvement initiatives.
The position involves working alongside health plan quality leaders to oversee quality data collection strategies, analytics, reporting, and external vendor engagement. Responsibilities include tracking quality rates, managing CAHPS survey analytics, monitoring health equity initiatives, and handling quality data ingestion tasks. The successful candidate will analyze data to find improvement opportunities, ensure regulatory audit compliance, and partner with cross-functional teams to eliminate gaps in quality care.
This opportunity suits professionals with background experience in healthcare, project management, and quality performance who possess strong quantitative, critical-thinking, and analytical capabilities.
Responsibilities
- Collaborate with health plan quality leaders to manage quality data collection strategy, analytics, and reporting for rate trending, provider measurement, CAHPS surveys, health equity, and external vendors
- Monitor quality-related projects from inception through successful delivery
- Oversee data validation, issue identification, and documentation to improve electronic health record and supplemental data accuracy
- Analyze quality data to discover performance improvement opportunities
- Ensure compliance with regulatory audit guidelines to maximize national HEDIS audit success
- Partner with cross-functional teams to deliver quality data and close care gaps
- Create, review, and update quality-related documentation, plans, reports, and records
- Communicate status reports regarding progress, risks, and issues to stakeholders
Requirements
- At least three years of program or project management experience in quality, or an equivalent combination of education and experience
- Healthcare experience or demonstrated functional quality knowledge
- Proficiency in 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 matrixed organization
- Effective verbal, written, and presentation communication skills
- Proficiency with Microsoft Office suite including Excel, with the ability to learn new software
Qualifications
- Familiarity with running queries in Microsoft Azure or SQL server
- Intermediate knowledge regarding NCQA, HEDIS, CMS, and state-specific regulatory submission requirements
- Knowledge of healthcare claim elements such as CPT, CPTII, LOINC, SNOMED, HCPCS, NDC, CVX, NPIs, and TINs
- Experience working in a cross-functional, highly matrixed organization within a managed care setting supporting Medicaid, Medicare, or Marketplace programs
- Project Management Professional certification
- Six Sigma Green Belt or Black Belt certification, or comparable coursework
Core Skills
Benefits
- Competitive benefits and compensation package
Frequently Asked Questions
Answers are based only on the employer’s listing; where it doesn’t say, neither do we.
Is this position remote?
Yes, the job posting indicates that the role is remote.
What is the employment type?
The position is full-time.
What salary is offered for this role?
The salary is not specified in the job posting.
How do current Molina employees apply?
Current employees are instructed to apply through the Internal Job Board.
Sample Interview Questions
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