Director of Health Plan Quality & Performance Improvement

Molina Healthcare, Inc.; City of Rochester (NY); Remote; USD 97,000 - 228,000; Full time

Job summary

Molina Healthcare, Inc. is seeking a senior leader to drive quality management and performance improvement across health plans. You will oversee NCQA accreditation activities, ensure HEDIS compliance, and guide cross-functional teams in regulatory reporting and process improvement.

The role requires strategic thinking, strong data analysis, and the ability to lead large, matrixed teams while maintaining state/federal contract compliance and effective stakeholder communication.

Qualifications

• 8+ years in health care with 5+ years in health plan quality improvement.
• 3+ years management/leadership experience.
• Advanced knowledge of HEDIS/NCQA and CAHPS improvements.
• Experience with Medicaid, Medicare, Marketplace programs.
• Strong business writing and data-driven decision-making.

Responsibilities

• Directs team responsible for quality management and improvement activities.
• Oversees health plan quality programs to meet NCQA and regulatory requirements.
• Represents senior leadership at national and state meetings as SME for quality.
• Collaborates with analytics and strategy teams to assess QPMP activities.
• Maintains policies, procedures, reports, and KPI tracking for quality work.
• Hires, trains, and manages staff to achieve quality goals and compliance.

Skills

HEDIS/NCQA

Data analysis

Leadership

CAHPS improvement

Project management

Communication

Excel

Policy compliance

Job description

Molina Healthcare, Inc. is seeking a senior leader to drive quality management and performance improvement across health plans. You will oversee NCQA accreditation activities, ensure HEDIS compliance, and guide cross-functional teams in regulatory reporting and process improvement.

The role requires strategic thinking, strong data analysis, and the ability to lead large, matrixed teams while maintaining state/federal contract compliance and effective stakeholder communication.