Director, National HEDIS Data & Quality Improvement

Molina Healthcare; United States; Remote; USD 96,000 - 209,000; Full time

Job summary

Molina Healthcare is seeking an experienced senior leader to drive enterprise clinical data acquisition, HEDIS and related risk adjustment projects, and SDS/EMR initiatives. You will guide a team, oversee chart collection, vendor management, and training to ensure high-quality data for performance reporting.

The role emphasizes collaboration with quality leaders, delivering KPI-driven updates to national and plan leadership, and presenting actionable insights to guide strategy.

Qualifications

• At least 8 years in managed care quality, including 4+ years in health plan quality or process improvement.
• At least 3 years of management/leadership experience.
• Advanced experience with HEDIS programs.
• Technical experience in reporting and/or programming.
• Advanced data analysis, manipulation and interpretation experience.
• Strong communication and presentation skills.
• Cross-functional collaboration in a matrixed environment.
• Attention to detail and time-management skills.

Responsibilities

• Plan and implement HEDIS operations meeting state and federal reporting requirements.
• Develop targeted data acquisition for performance reporting and outreach.
• Serve as SME for HEDIS operations with roadmap, timeline and KPIs.
• Collaborate with analytics teams to deliver value for programs.
• Communicate deliverables, timelines, barriers to leadership.
• Present concise summaries at meetings.
• Lead cross-functional teams overseeing quality projects.
• Oversee chart review/abstraction and reporting.
• Manage production vendor relationships with KPIs.
• Hire, train, and manage team to meet goals.

Skills

HEDIS expertise

Data analysis

Leadership

Programming

Cross-functional collaboration

Communication

Microsoft Office

Problem solving

Education

CPHQ

CHCA

RN license

Bachelor’s degree in healthcare

Tools

Microsoft Office

Job description

Molina Healthcare is seeking an experienced senior leader to drive enterprise clinical data acquisition, HEDIS and related risk adjustment projects, and SDS/EMR initiatives. You will guide a team, oversee chart collection, vendor management, and training to ensure high-quality data for performance reporting.

The role emphasizes collaboration with quality leaders, delivering KPI-driven updates to national and plan leadership, and presenting actionable insights to guide strategy.