Remote Health Plan Quality & Performance Lead

Molina Healthcare; Lake Michigan Beach (MI); A distancia; USD 110.000 - 170.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Competitive benefits package

Descripción de la vacante

Molina Healthcare is seeking a remote Health Plan Quality Program Mgt & Performance Manager with Michigan Medicaid/Managed Care experience. The role focuses on quality improvement, NCQA accreditation support, and regulatory compliance across state and federal programs.

Travel 0-50% may be required, with potential multi-day trips. Requirements include 6+ years in health care with 4+ years in health plan QI, CP HQ/CHCA certifications preferred, and strong data analysis, reporting, and leadership

Formación

• Experience focusing on quality improvement compliance deliverables with state/federal regulators.
• NCQA/HEDIS experience related to QI.
• Experience managing multiple high-priority deliverables and meeting deadlines.
• Strong business writing experience.
• Proficiency with data analysis, manipulation, interpretation and reporting.
• Project management experience.

Responsabilidades

• Provide leadership for quality management and quality performance improvement activities.
• Oversee planning and implementation of health plan quality improvement activities for NCQA accreditation and regulatory compliance.
• Lead quality improvement activities and cross-functional meetings to meet regulatory requirements.
• Prepare and finalize quality program management documentation and follow-up actions.
• Monitor key quality activities and present results to leaders and committees.
• Maintain quality program management plans and addendums with state and NCQA requirements.
• Collaborate with state and national quality leadership to document activities and requirements.
• Create, manage, and compile documentation for quality improvement functions.
• Lead problem-solving and remediation for quality escalations with leadership.
• Provide training and support to team members.
• Travel 0-50% of the time; multi-day overnight travel 0-20% as needed.

Conocimientos

QI compliance

NCQA/HEDIS knowledge

multi-project management

regulatory reporting

data analysis

training & onboarding

travel readiness

Educación

CPHQ

CHCA

Herramientas

Excel

Descripción del empleo

Molina Healthcare is seeking a remote Health Plan Quality Program Mgt & Performance Manager with Michigan Medicaid/Managed Care experience. The role focuses on quality improvement, NCQA accreditation support, and regulatory compliance across state and federal programs.

Travel 0-50% may be required, with potential multi-day trips. Requirements include 6+ years in health care with 4+ years in health plan QI, CP HQ/CHCA certifications preferred, and strong data analysis, reporting, and leadership