Sr. Risk & Quality Performance Manager (Remote)

Lensa; Savannah (GA); Remote; USD 77,000 - 172,000; Full time

Job summary

An established industry player is seeking a Sr. Risk & Quality Performance Manager to lead strategic projects within their Risk & Quality Solutions team. This pivotal role involves enhancing performance through data analytics, managing program changes, and building stakeholder relationships. The ideal candidate will bring extensive experience in program management, particularly in risk adjustment and quality, along with strong analytical skills. This full-time remote position offers a competitive salary and the opportunity to make a significant impact in the healthcare sector.

Qualifications

• 4+ years in program/project management in risk adjustment and/or quality.
• Experience supporting HEDIS engine activities and data analysis.

Responsibilities

• Partner with leaders to enhance outcomes through data collection and analytics.
• Manage data ingestion activities and optimize impacts.

Skills

Program/Project Management

Data Analysis

SQL Server

Microsoft Office Suite

Healthcare Knowledge

Stakeholder Collaboration

Education

Bachelor's Degree

Graduate Degree

Tools

SQL

Microsoft Excel

Microsoft Project

Job description

Sr. Risk & Quality Performance Manager (Remote)

The Sr. Risk & Quality Performance Manager is a strategic role responsible for leading projects that support Molina’s Risk & Quality Solutions (RQS) team. The position involves collaborating with various departments to plan, coordinate, and execute performance improvement initiatives aligned with RQS’s strategic objectives.

Key Responsibilities

• Partner with Risk and Quality leaders to enhance outcomes through data collection, analytics, and reporting, including trend analysis, provider performance, survey analytics, health equity, and SDOH.
• Ensure timely delivery of programs within scope and resource constraints.
• Manage data ingestion activities, optimizing EHR/HIE and supplemental data impacts.
• Build and maintain effective relationships with stakeholders, ensuring customer expectations are met.
• Resolve complex problems via project management, data analytics, and stakeholder collaboration.
• Manage program changes, ensuring alignment with goals and updating leadership on progress.
• Draw actionable insights from data, make informed decisions, and communicate risks and issues proactively.
• Ensure all program documentation and reports are accurate, updated, and accessible.
• Support other team members as a subject matter expert and pivot as needed to support organizational needs.

Minimum Qualifications

• Bachelor’s degree or equivalent experience.
• 4+ years in program/project management in risk adjustment and/or quality.
• Experience supporting HEDIS engine activities, risk adjustment reporting, and data analysis.
• Proficiency with SQL Server or Microsoft Azure queries.
• Strong skills in Microsoft Office Suite, especially Excel and Project.
• Healthcare industry experience with solid risk adjustment and quality knowledge.
• Ability to collaborate across organizational levels and solve complex problems.

Preferred Qualifications

• Graduate degree or equivalent experience.
• Experience supporting leadership in a matrixed organization.
• SQL fluency and extensive healthcare claim knowledge (CPT, LOINC, SNOMED, etc.).
• Success in roles impacting Risk Adjustment and HEDIS.
• Certifications like PMP, Six Sigma Green/Black Belt are preferred.

Additional Details

This is a full-time, mid-senior level position with a pay range of $77,969 - $171,058 annually. The role is remote, supporting teams in Savannah, GA, and other locations. Molina Healthcare is an Equal Opportunity Employer and offers competitive benefits.