National Quality & Risk Program Manager

Molina Healthcare; United States; Remote; USD 80,000 - 172,000; Full time

Job summary

Molina Healthcare seeks a Quality Systems leader to oversee performance managers, ensuring delivery of quality initiatives, regulatory compliance, and alignment with enterprise priorities across a portfolio of quality data and improvement activities.

You will guide data-driven strategies, support NCQA/HEDIS submissions, and collaborate with cross-functional teams to produce meaningful reporting, analytics, and remediation plans while developing the team and maintaining high performance.

Qualifications

• 7+ years of program/project management experience in quality.
• At least 1 year of management/leadership experience.
• Comprehensive mastery of the drivers of value in managed health care, and in-depth knowledge of quality and the health care industry.
• Experience with NCQA/HEDIS, CMS, and state regulatory submissions is preferred.

Responsibilities

• Manages the Quality Systems team, including setting expectations and coaching to align with quality strategies and department goals.
• Supports the annual quality data submission process, including NCQA and state regulatory submissions.
• Develops data-focused strategies to improve data completeness and accuracy in ingestion activities including HIE data.
• Collaborates with leadership to improve program performance through reporting and analytics across CAHPS and other survey analytics.

Skills

Communication

Leadership

Problem-solving

Analytical thinking

Detail-oriented

Cross-functional collaboration

Project management

Tools

SQL server

Microsoft Azure

Excel

Databricks

Job description

Molina Healthcare seeks a Quality Systems leader to oversee performance managers, ensuring delivery of quality initiatives, regulatory compliance, and alignment with enterprise priorities across a portfolio of quality data and improvement activities.

You will guide data-driven strategies, support NCQA/HEDIS submissions, and collaborate with cross-functional teams to produce meaningful reporting, analytics, and remediation plans while developing the team and maintaining high performance.