National Quality & Risk Systems Manager

Remote Jobs; United States; Remote; USD 110,000 - 150,000; Full time

Benefits offered by this job

Benefits package

Job summary

Molina Healthcare is seeking a senior leader to oversee Quality Systems performance, ensuring teams are resourced and aligned with quality strategies and regulatory requirements. You will drive data-driven improvements and collaborate with leaders across plans to enhance performance and reporting.

Responsibilities include managing the team, supporting NCQA submissions, and developing data quality initiatives to close care gaps while maintaining high standards of performance.

Qualifications

• 7+ years of program or project management experience in quality, with HEDIS/QI exposure.
• 1+ year of management/leadership experience.
• Deep knowledge of healthcare quality and regulatory frameworks.

Responsibilities

• Lead and manage the Quality Systems team and align with quality strategies and goals.
• Support NCQA and state regulatory submissions.
• Design and develop data-focused strategies for data ingestion and quality.
• Collaborate with quality leaders and health plans on reporting and analytics (CAHPS, quality trends).
• Oversee quality project plans, resource assignment, and timely delivery within regulatory requirements.
• Identify barriers and develop mitigation strategies.
• Prioritize and resolve complex problems through cross-functional collaboration.
• Draw actionable conclusions and present recommendations to address quality issues.
• Conduct quality reviews and audits to maintain high performance standards.
• Address issues/discrepancies promptly to ensure program success.
• Develop data quality strategies to close care gaps.
• Communicate portfolio status, risks, and remediation plans with leadership.
• Foster a collaborative, high-performing team and support professional development.
• Hire, train, and manage the team and achieve department goals.

Skills

Program management

Leadership

Quality systems

Data analysis

SQL

Azure

Stakeholder management

Communication

Cross-functional

Collaboration

Data quality

Problem solving

Attention to detail

Regulatory compliance

Tools

SQL Server

Azure

Excel

Microsoft Office

Power BI

Job description

Molina Healthcare is seeking a senior leader to oversee Quality Systems performance, ensuring teams are resourced and aligned with quality strategies and regulatory requirements. You will drive data-driven improvements and collaborate with leaders across plans to enhance performance and reporting.

Responsibilities include managing the team, supporting NCQA submissions, and developing data quality initiatives to close care gaps while maintaining high standards of performance.