Health Plan Quality & Performance Program Lead

Molina Healthcare, Inc.; United States; Remote; USD 110,000 - 140,000; Full time

Job summary

Molina Healthcare, Inc. is seeking a seasoned quality management leader to oversee and drive quality improvement activities across health plans. You will ensure NCQA/HEDIS compliance and regulatory alignment, provide SME support for quality initiatives, and lead documentation, audits, and reporting processes.

The role requires strong analytical, writing, and project management skills, with the ability to work with cross-functional teams and state/federal stakeholders. Some travel may be required.

Qualifications

• Experience with health plan quality improvement and NCQA/HEDIS compliance requirements.
• Strong writing, reporting, and data interpretation skills.
• Ability to drive process improvements and manage projects in a fast-paced environment.
• Knowledge of state and federal quality program requirements.

Responsibilities

• Lead quality program management activities to ensure NCQA and regulatory compliance.
• Provide SME support for quality-related projects and initiatives.
• Prepare and finalize quality program meeting documentation and follow-up actions.
• Oversee preparation for quality improvement reports, audits, and surveys.
• Monitor completion of key quality activities and present results to leaders and committees.
• Collaborate with leadership to maintain up-to-date quality policies and procedures.
• Create and manage documentation for critical quality improvement functions.
• Lead cross-functional quality improvement discussions and escalation remediation.

Skills

HEDIS/NCQA

Data analysis

Quality improvement

Regulatory compliance

Project management

Attention to detail

Communication skills

Education

CPHQ certification

CHCA certification

RN licensure (active)

Tools

Excel

Microsoft Office

Job description

Molina Healthcare, Inc. is seeking a seasoned quality management leader to oversee and drive quality improvement activities across health plans. You will ensure NCQA/HEDIS compliance and regulatory alignment, provide SME support for quality initiatives, and lead documentation, audits, and reporting processes.

The role requires strong analytical, writing, and project management skills, with the ability to work with cross-functional teams and state/federal stakeholders. Some travel may be required.