Job Description

Job Summary

The Manager, Quality Program Management and Performance oversees and leads activities to maintain compliance with state requirements and federal and/or NCQA quality requirements, as appropriate in collaboration with quality leadership. Manages quality program management activities to ensure compliance with regulatory requirements, including managing staff.

Job Duties

Oversees and leads activities to maintain compliance with state requirements and federal and/or NCQA quality requirements, as appropriate in collaboration with quality leadership with implementation of Health Plan quality program management and performance activitiesManages quality program management activities to ensure compliance with regulatory requirements, including managing staffMaintains structure and processes for quality program management, including maintenance and modification of quality policies and procedures, management and oversight of committee and workgroup structure and document management, report completion to meet requirements, and tracking of key deliverablesPrepares written reports and documents that clearly outline the quality program activities and ensure that member and provider feedback is incorporated into quality program management meetings, outcomes from these activities are documented, and continuous quality improvement tools are used to highlight the processes, interventions, and remeasurements are conducted to meet improvement goalsMaintains ongoing revision of policies and procedures reflective of state requirements (and/or federal and NCQA requirements, as appropriate) for all quality program management functions by overseeing the ongoing incorporation and modification of requirements into state-specific policy addendumsManages training and education of quality program management and performance staff about completion of quality program management and performance activities in line with regulatory requirementsEnsures all quality program management and performance staff are well-versed in the requirements of the quality program and day-to-day work processes to support compliance with state contracts, policies and procedures, and program requirementsImplements tracking and trending of quality program requirements on an ongoing basis, including operational key performance indicators, process reviews, and gap analysesUtilizes proven quality improvement methods, such as the Plan-Do-Study-Act (PDSA) cycle, to facilitate individual, team, and organizational process improvementDemonstrates flexibility when it comes to changes and maintains a positive outlookHas excellent conflict resolution problem-solving skillsThis position may require same-day out-of-office travel 0 - 50% of the time, depending on the locationThis position may require multiple days out of town overnight travel 0 - 20% of the time, depending upon location

Job Qualifications

REQUIRED QUALIFICATIONS:

Bachelor's Degree or equivalent combination of education and work experience5-7 years of experience in healthcare with a minimum of 2 years’ experience in health plan quality management improvement, managed care, or equivalent experienceDemonstrated solid business writing experienceOperational knowledge and experience with Excel and Visio (flow chart equivalent)

PREFERRED QUALIFICATIONS:

Advanced degree in Nursing, Public Health, Health Administration, Social Work, or related fieldHEDIS reporting or collectionCAHPS improvement experienceState QI experienceMedicaid experienceSupervisory experienceProject management and team building experienceCertified Professional in Health Quality (CPHQ)Nursing License (RN may be preferred for specific roles)Certified HEDIS Compliance Auditor (CHCA)

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

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Pay Range: $76,757 - $149,676 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Type: Full Time Posting Date: 06/19/2025