Senior Health Plan Quality & Performance Leader

Molina Healthcare, Inc.; Texas; Remote; USD 66,000 - 120,000; Full time

Job summary

Molina Healthcare, Inc. seeks a seasoned quality management leader to oversee and advance health plan quality improvement programs, ensuring NCQA accreditation readiness and HEDIS compliance across states.

The role requires at least 6 years in healthcare with 4+ years in health plan quality, strong data analysis skills, and the ability to drive cross‑functional initiatives. Occasional travel is expected to support audits and performance improvement activities.

Qualifications

• At least 6 years of healthcare experience with 4+ years in health plan quality improvement.
• Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates
• Strong knowledge of HEDIS/NCQA.
• Solid business writing experience.
• Proficiency with data analysis, manipulation, interpretation and reporting.
• Ability to implement process improvement initiatives and work independently in a fast-paced environment.
• Project management experience.
• Strong verbal and written communication skills.
• Microsoft Office suite (including Excel) proficiency, and ability to learn new information systems and software programs.

Responsibilities

• Drive quality program management to ensure compliance with NCQA, state and federal requirements.
• Serve as SME to quality management team; support quality-related projects and initiatives and ensure programs meet regulatory requirements.
• Prepare and finalize quality program documentation and action tracking with clear next steps.
• Oversee complex quality program activities including audits and surveys for NCQA/federal/state requirements.
• Monitor timely completion of activities and present results to leaders and formal committees.
• Prepare narrative reports and interpret regulatory specifications and program results.
• Maintain project plans to document NCQA/state requirements.
• Collaborate with state and national quality leadership to update policies and procedures.
• Create and compile documentation to maintain critical quality improvement functions.
• Lead quality improvement meetings with cross-functional departments.
• Evaluate activities to identify opportunities for improvement.
• Engage in problem-solving and remediation of escalations with quality leadership.
• Provide training and support for team members.
• Travel: 0-50% local/state; 0-20% overnight stays as needed.

Skills

HEDIS/NCQA knowledge

Data analysis

Project management

Communication skills

Business writing

Excel proficiency

Tools

Microsoft Office

Job description

Molina Healthcare, Inc. seeks a seasoned quality management leader to oversee and advance health plan quality improvement programs, ensuring NCQA accreditation readiness and HEDIS compliance across states.

The role requires at least 6 years in healthcare with 4+ years in health plan quality, strong data analysis skills, and the ability to drive cross‑functional initiatives. Occasional travel is expected to support audits and performance improvement activities.