Senior Program Manager, Medicare Stars & Quality Improvement (Remote)

Molina Healthcare; United States; On-site; USD 72,000 - 140,000; Full time

Benefits offered by this job

Benefits package

EOE employer

Job summary

Molina Healthcare seeks a Senior Manager, Medicare Stars Quality Improvement to lead enterprise Medicare Star programs. You will plan and execute QI initiatives, develop training, and measure outcomes across health plan teams.

You will collaborate with cross-functional stakeholders, manage budgets and schedules, and guide vendor work as needed. Strong data analysis, leadership, and program management experience are essential, with deep knowledge of Medicare Stars metrics and government-sponsored

Qualifications

• 7+ years in Medicare Stars program and project management
• Strong knowledge of Medicare Star ratings and QI programs
• Advanced quality discipline knowledge including metrics and standards
• Experience with government-sponsored programs (Medicaid, Medicare)
• Experience developing performance measures to support business objectives
• Excellent business writing and communication skills

Responsibilities

• Collaborates with cross-functional teams to develop and implement Medicare Stars QI programs
• Manages, plans and executes Stars ratings programs; supports program staff and leadership
• Monitors outcomes and develops initiatives to improve Star ratings
• Acts as Medicare Stars SME to corporate areas and health plans
• Translates measures into functional requirements to maximize improvements
• Leads leadership discussions and provides recommendations based on performance data
• Plans, directs schedules and budgets for program initiatives

Skills

Medicare Stars program management

Data analysis & reporting

Cross-functional collaboration

Project management

Stakeholder communication

Tools

Excel

Microsoft Office

Job description

JOB DESCRIPTION Job Summary

Provides deep subject matter expertise and leadership for Medicare Stars quality improvement (QI) programs and activities. Plans and implements QI initiatives and education programs to support improved Medicare Star ratings. Responsible for leading and managing Medicare Star projects and programs involving enterprise, department, cross-functional and health plan teams of subject matter experts, delivering impactful QI initiatives through design process to completion and outcomes measurement.

Essential Job Duties

• Collaborates with cross-functional corporate and health plan teams on the development and implementation of Medicare Stars quality improvement (QI) programs and initiatives.
• Manages, plans and executes Medicare Star ratings programs; monitors work of associated program staff as applicable, and provides support and direction in collaboration with leadership.
• Supports Stars program execution and governance needs; communicates, measures outcomes and develops initiatives to improve Star ratings.
• Serves as the Medicare Stars subject matter expert to corporate functional areas/health plans, and leads programs to meet critical needs.
• Communicates and collaborates with Stars measure owners to analyze and transform needs and goals into functional requirements to maximize improvement opportunities.
• Leads health plan leadership discussions to provide recommendations, performance results and opportunity assessments for Medicare Stars improvement.
• Collaborates with operational leaders within the business to provide recommendations on opportunities for

process improvements, organizational change management, program management and other processes related to Medicare Star ratings.

• Facilitates process improvement, organizational change management, program management and other processes relative to the Medicare Stars Program.
• Plans and directs schedules for program initiatives, as well as program budgets.
• Develops, defines, and executes plans, schedules, and deliverables; monitors programs from initiation

through delivery through outcomes measurement.

• Monitors and tracks key performance indicators (KPIs), programs and initiatives to reflect the value and effectiveness of Stars and QI programs.
• Creates business requirements documents, test plans, requirements traceability matrix, user training materials and other related documents.
• Monitors projects from inception through delivery and outcomes measurement.
• May engage and oversee the work of external vendors.
• Generates and distributes quality improvement/Medicare Stars standard reports timely.
• Provides subject matter expertise, support and training to new and existing Medicare Stars QI team members.

Required Qualifications

• At least 7 years of Medicare Stars program and project management experience, or equivalent combination of relevant education and experience.
• Strong knowledge of and experience with Medicare Star ratings and QI programs.
• Advanced knowledge of the quality discipline, including metrics and performance standards.
• Experience with government-sponsored programs (Medicaid, Medicare, Marketplace).
• Experience developing performance measures that support business objectives.
• Solid business writing experience.
• Strong strategic-thinking skills.
• Strong proficiency with data analysis, manipulation, interpretation, reporting and data-driven decision-making.
• Critical-thinking, problem-solving and analytical skills.
• Attention to detail and organizational skills.
• Ability to implement process improvement initiatives and drive change.
• Ability to work independently in a fast-paced, deadline-driven environment.
• Ability to work in a cross-functional highly matrixed organization.
• Strong project management experience.
• Excellent verbal, written, and presentation communication skills.
• Microsoft Office suite (including Excel), and applicable software programs proficiency, and ability to learn new information systems and software programs.

Preferred Qualifications

• Deep Medicare Stars/quality improvement (QI) program experience.
• Six Sigma Black Belt Certification.
• ITIL (Information Technology Infrastructure Library) certification.
• Experience in leading significant cross-functional work.
• Extensive project management experience.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $72,370.82 - $140,000 / ANNUAL

• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.