Director, Health Plan Quality & Performance Improvement

Molina Healthcare; New York (NY); Remote; USD 97,000 - 228,000; Full time

Benefits offered by this job

Competitive benefits package

Job summary

Molina Healthcare seeks an experienced leader to direct quality management and performance improvement across the health plan. You will oversee NCQA accreditation activities, implement HEDIS regulations, and guide teams through surveys, audits, and data-driven improvement initiatives.

Responsibilities include policy management, reporting, and cross-functional collaboration with analytics and leadership to drive KPIs and outcomes. Travel requirements may apply based on state needs.

Qualifications

• 8+ years in health care with 5+ years in health plan quality improvement.
• Minimum 3 years of management/leadership experience.
• Advanced knowledge of HEDIS/NCQA.
• CAHPS improvement experience.
• Experience with government-sponsored programs (Medicaid, Medicare, Marketplace).
• Strong writing, data-driven decision making and analytical skills.
• Proficient in Excel and analytics software.

Responsibilities

• Directs team for quality program management strategies, audits and surveys.
• Oversees health plan quality program management in NCQA-compliant ways.
• Represents senior leadership at national/regional meetings as SME.
• Collaborates with analytics to evaluate QPMP activities.
• Maintains policies, procedures, governance and document management.
• Prepares reports outlining quality program activities and outcomes.
• Updates policies per state/NCQA requirements; manages training.
• Ensures staff are versed in program requirements and processes.
• Implements tracking of KPIs, reviews, and gap analyses.
• Applies PDSA cycles for process improvement.
• Hires, trains and manages the team; travel up to 25% as needed.

Skills

Quality improvement

HEDIS/NCQA knowledge

CAHPS improvement

Data analysis

Leadership

Project management

Communication

Education

CPHQ

CHCA

RN

Tools

Excel

Job description

Molina Healthcare seeks an experienced leader to direct quality management and performance improvement across the health plan. You will oversee NCQA accreditation activities, implement HEDIS regulations, and guide teams through surveys, audits, and data-driven improvement initiatives.

Responsibilities include policy management, reporting, and cross-functional collaboration with analytics and leadership to drive KPIs and outcomes. Travel requirements may apply based on state needs.