Strategic Program Director: Risk & Quality Solutions

Molina Healthcare; United States; Remote; USD 110,000 - 170,000; Full time

Job summary

Molina Healthcare is seeking a senior professional to provide deep expertise in enterprise risk and quality solutions. You will collaborate with health plan leaders to implement best practices, ensure complete action plans, and drive performance toward established risk and quality goals.

The role requires extensive managed care experience, leadership capability, and strong analytical skills to support Medicaid, Medicare, and Marketplace initiatives across state plans.

Qualifications

• At least 8 years of managed care experience, including risk adjustment/quality-related experience.
• At least 3 years of management/leadership experience.
• Proficiency with risk adjustment methodologies.
• Quality/risk operational and process improvement experience.
• Proficiency with data analysis, manipulation and interpretation.
• Excellent verbal/written communication skills and presentation skills.

Responsibilities

• Supports state health plans with risk and quality solutions to meet risk/quality goals under senior leadership.
• Acts as a risk/quality SME to functional areas and leads related programs.
• Escalates gaps and barriers to leadership and coordinates resolution with the execution team.
• Develops business case methodologies for incremental risk/quality programs.
• Collaborates with corporate and health plan teams on risk/quality activities.

Skills

Risk adjustment methodologies

Quality improvement

Data analysis

Project management

Communication skills

Leadership

Cross-functional collaboration

Attention to detail

Problem solving

Microsoft Office

Job description

Molina Healthcare is seeking a senior professional to provide deep expertise in enterprise risk and quality solutions. You will collaborate with health plan leaders to implement best practices, ensure complete action plans, and drive performance toward established risk and quality goals.

The role requires extensive managed care experience, leadership capability, and strong analytical skills to support Medicaid, Medicare, and Marketplace initiatives across state plans.