Executive Leader, Clinical Performance & Quality Strategy

Molina Healthcare; United States; À distance; USD 180 000 - 280 000; Plein temps

Avantages offerts par ce poste

Competitive benefits

Résumé du poste

Molina Healthcare is seeking an enterprise executive to lead clinical operations, ensuring regulatory compliance, quality, and financial performance. The role oversees UM/CM/LTSS audits, HEDIS/Stars, workforce strategy, vendor governance, and standardized staffing models, with travel ~25% across the United States.

Ideal candidate brings 12+ years in managed care, 7+ years in healthcare leadership, and relevant licensure/certification as required.

Qualifications

• At least 12 years managed care experience in a matrixed organization.
• At least 7 years health care management/leadership experience.
• Clinical licensure and/or certification required only if state-mandated; must be active.
• Strong operational/process improvement experience and cross-team collaboration.

Responsabilités

• Provide executive oversight for clinical UM, CM, and LTSS audit programs.
• Lead centralized clinical audit team, ensuring compliance and reporting.
• Oversee clinical workforce planning, capacity, and analytics.
• Drive HEDIS/Stars strategies and measure optimization.
• Oversee vendor/delegated entity performance and contracts.
• Develop standardized staffing models and productivity benchmarks.
• Partner with Finance and Data teams to improve quality and outcomes.
• Travel as needed, approx. 25%.

Connaissances

Executive leadership

Healthcare operations

Regulatory compliance

Strategic planning

Data analytics

Vendor governance

Cross-functional leadership

Communication skills

MS Office

Formation

Registered Nurse (RN)

CPHM/CPHQ

Outils

MS Office

Description du poste

Molina Healthcare is seeking an enterprise executive to lead clinical operations, ensuring regulatory compliance, quality, and financial performance. The role oversees UM/CM/LTSS audits, HEDIS/Stars, workforce strategy, vendor governance, and standardized staffing models, with travel ~25% across the United States.

Ideal candidate brings 12+ years in managed care, 7+ years in healthcare leadership, and relevant licensure/certification as required.