National Quality Performance Manager (Remote)

About the role

Molina's quality performance solutions team seeks a subject matter expert to provide support and leadership in quality performance initiatives.

Responsibilities

• Collaborates with health plan quality leaders to improve outcomes by managing quality data collection strategy, analytics, and reporting for various metrics.
• Maintains and enhances quality data integrity through data validation, issue identification, and documentation.
• Analyzes quality data to identify performance improvement opportunities and ensures compliance with regulatory audit guidelines.
• Partners with cross-functional teams to ensure data quality delivery and close quality care gaps.
• Creates, reviews, and updates quality-related program documentation and communicates regular status reports to stakeholders.
• Works collaboratively in a matrixed organization to meet customer expectations and establish trust and respect.

Requirements

• At least 3 years of program/project management experience in quality, or equivalent combination of relevant education and experience.
• Health care experience or demonstrated functional quality knowledge.
• Intellectual agility and ability to simplify and clearly communicate complex concepts.
• Proficiency with 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 highly matrixed organization.
• Effective verbal, written, and presentation communication skills.
• Microsoft Office suite (including Excel) and applicable software programs proficiency, and ability to learn/navigate new software programs.

Preferred Qualifications

• Familiarity with running queries in Microsoft Azure or Structured Query Language (SQL) server.
• Intermediate knowledge/experience related to NCQA, HEDIS, CMS, and state-specific regulatory submission requirements.
• Knowledge of health care claim elements: CPT, CPTII, LOINC, SNOMED, HCPS, NDC, CVX Codes, NPIs, TINs.
• Experience working in a cross-functional, highly matrixed organization, preferably within a managed care organization supporting Medicaid, Medicare, and/or Marketplace programs.
• Project Management Professional (PMP) certification.
• Six Sigma Green Belt or Black Belt certification, and/or comparable coursework.