Director, Quality Improvement & NCQA Strategy

Molina Healthcare; United States; On-site; USD 72,000 - 157,000; Full time

Job summary

Molina Healthcare is seeking a senior Quality Improvement Leader to provide subject matter expertise and leadership for QI initiatives and education programs. You will oversee data collection, reporting, and monitoring for KPI activities and direct NCQA accreditation surveys and government QI compliance efforts.

You will guide senior leadership on quality strategies, manage QI programs with state health plans, and ensure timely follow-up and communication with stakeholders.

Qualifications

• 8+ years in health care with at least 5 years in health plan quality improvement/compliance.
• At least 3 years of management/leadership experience.
• Deep knowledge of quality discipline, including metrics and performance standards.
• Advanced knowledge of HEDIS/NCQA, including NCQA accreditation experience.
• CAHPS improvement experience.
• HEDIS reporting/collection experience.
• Medicare Stars program experience.
• Experience with government-sponsored programs (Medicaid, Medicare, Marketplace).
• Experience developing performance measures that support business objectives.

Responsibilities

• Leads quality programs/projects in HEDIS performance measurement, quality reporting, and NCQA accreditation activities.
• Serves as a quality improvement subject matter expert and advises senior leaders on quality strategies.
• Manages QI programs and interventions in collaboration with senior quality leadership.
• Collaborates with corporate functions and state health plans on QI activities.
• Leads corporate quality initiatives with tracking and stakeholder communications.
• Monitors key quality indicators and ensures effectiveness of QI programs.
• Develops and implements automated reporting and interventions tools.
• Collaborates cross-functionally to improve reporting and use of quality reporting tools.
• Leads clinical intervention activities and quality initiatives at national/state levels.
• Ensures timely communication of interventions and program effectiveness.
• Facilitates high-quality clinical care/services through inter-department collaboration.
• Provides training and support to quality team members.

Skills

HEDIS/NCQA

Quality Improvement

Data Analysis

Project Management

Leadership

Healthcare Experience

CAHPS

Policy/Compliance

Tools

Excel

Quality Reporting Tools

Job description

Molina Healthcare is seeking a senior Quality Improvement Leader to provide subject matter expertise and leadership for QI initiatives and education programs. You will oversee data collection, reporting, and monitoring for KPI activities and direct NCQA accreditation surveys and government QI compliance efforts.

You will guide senior leadership on quality strategies, manage QI programs with state health plans, and ensure timely follow-up and communication with stakeholders.