Program Manager, Medicare Stars & Quality Improvement (Remote in Kentucky)

Overview

Passport Health Plan by Molina Healthcare has a mission to provide quality health care to those who need it, no matter their circumstances. Today, Molina health plans serve 3,331,000 members across the country through government-funded programs. Each day, we work to earn the trust our partners and members put in us, so they can lean on Molina. Together, Passport Health Plan and Molina share a commitment to improving the health and quality of life of our members across the Commonwealth of Kentucky.

Success Profile

What makes you successful at Passport Health Plan by Molina Healthcare? Check out the traits we’re looking for and see if you're the right fit!

• Compassionate
• Consultative
• Patient
• Problem-Solver
• Sincere
• Relationship Expertise

Benefits

• Insurance: Medical · Dental · Vision
  Group & Voluntary Life Insurance
  Aflac · Pet Health · Identity Theft
  Auto & Home Insurance

• Savings: Flexible Spending Accounts
  401K · Roth 401K
  Employee Stock Purchase Plan

• Career Growth: Continuing Education Units
  Education Reimbursement

• Time Off: Paid Time Off
  Volunteer Time Off
  Company Holidays

• Additional Benefits: Legal Assistance Plan
  Employee Assistance & Well Being Programs
  Employee Perks Platform
  Rideshare Portal

Responsibilities

Provides subject matter expertise and leadership for Medicare Stars quality improvement (QI) programs and activities. Provides subject matter expertise in planning and implementing QI initiatives and education programs to support improved Medicare Star ratings. Responsible for leading and managing Medicare Star projects and programs involving enterprise, department, cross-functional and health plan teams of subject matter experts, delivering impactful quality improvement initiatives through design process to completion and outcomes measurement.

• Collaborates with cross-functional corporate and health plan teams on the development and implementation of enterprise Medicare Stars quality improvement (QI) programs and initiatives across the enterprise.

• Manages, plans and executes Medicare Star ratings programs.

• Serves as the Medicare Stars subject matter expert to corporate functional areas/health plans, and leads programs to meet critical needs.

• Communicates and collaborates with health plans and Stars measure owners to analyze and transform needs and goals into functional requirements to maximize improvement opportunities.

• Leads health plan leadership discussions to provide recommendations, performance results and opportunity assessments for Medicare Stars improvement.

• Collaborates with operational leaders within the business to provide recommendations on opportunities for process improvements, organizational change management, program management and other processes related to Medicare Star ratings.

• Facilitates process improvement, organizational change management, program management and other processes relative to the Medicare Stars Program.

• Plans and directs schedules for program initiatives, as well as program budgets.

• Develops, defines, and executes plans, schedules, and deliverables; monitors programs from initiation through delivery through outcomes measurement.

• Maintains and monitors key performance indicators (KPIs), programs and initiatives to reflect the value and effectiveness of Stars and QI programs.

• Creates business requirements documents, test plans, requirements traceability matrix, user training materials and other related documents.

• Monitors projects from inception through delivery and outcomes measurement.

• May engage and oversee the work of external vendors.

• Generates and distributes quality improvement/Medicare Stars standard reports timely.

Required Qualifications

• At least 6 years of Medicare Stars program and project management experience, or equivalent combination of relevant education and experience.

• Demonstrated knowledge of and experience with Medicare Star ratings and QI programs.

• Advanced knowledge of the quality discipline, including metrics and performance standards.

• Experience with government-sponsored programs (Medicaid, Medicare, Marketplace).

• Experience developing performance measures that support business objectives.

• Solid business writing experience.

• Strong strategic-thinking skills.

• Strong proficiency with data analysis, manipulation, interpretation, reporting and data-driven decision-making.

• Critical-thinking, problem-solving and analytical skills.

• Attention to detail and organizational skills.

• Ability to implement process improvement initiatives and drive change.

• Ability to work independently in a fast-paced, deadline-driven environment.

• Ability to work in a cross-functional highly matrixed organization.

• Strong project management experience.

• Excellent verbal, written, and presentation communication skills.

• Microsoft Office suite (including Excel), and applicable software programs proficiency, and ability to learn new information systems and software programs.

Preferred Qualifications

• Strong Medicare Stars/quality improvement (QI) program experience.

• Six Sigma Black Belt Certification.

• ITIL (Information Technology Infrastructure Library) certification.

• Experience in leading significant cross-functional work.

• Strong project management experience.

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.

Pay Range

$69,447 - $142,548.59 / ANNUAL

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