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Molina Healthcare · 1 month ago

Senior Specialist, Quality Program Management & Performance (Remote in Nevada)

United States

Full-time

Remote

Mid, Senior Level

3+ years exp

Molina Healthcare is a leading organization in the healthcare sector, and they are seeking a Senior Specialist in Quality Program Management & Performance. This role involves implementing healthcare quality improvement activities, ensuring compliance with quality program requirements, and providing guidance to other specialists and departments.

Health CareHospitalMedical

Responsibilities

Acts as a lead specialist to provide project-, program-, and/or initiative-related direction and guidance for other specialists within the department and/or collaboratively with other departments to ensure quality programs meet regulatory requirements

Implements key quality program activities that maintain quality compliance, including maintaining responsibility for preparing and finalizing quality program management committee and other meeting documentation, which capture thorough discussion and participation of attendees, follow-up actions, and next steps, in a clear and understandable way

Oversees quality program management activities, which include preparation for quality improvement audits, surveys, and other federal and state-required quality activities

Monitors and ensures that key quality activities are completed on time and accurately to present results to key departmental management and other Molina departments, and to formal committees and subcommittees as needed

Writes narrative reports and works with departmental specialists (as appropriate) to interpret regulatory specifications, explain programs and results of programs, and document findings

Maintains quality program management project plan to ensure state (and/or federal and NCQA-related) requirements are documented during the year

Works with the Manager and/or Director to maintain up-to-date addendums to quality policies and procedures that clearly document state-specific activities and requirements in collaboration with the national teams

Creates, manages, and/or compiles the required documentation to maintain critical quality improvement functions

Leads quality improvement activities, meetings, and discussions with and between other departments within the organization

Evaluates project/program activities and results to identify opportunities for improvement

Surfaces to the Manager and/or Director any gaps in processes that may require remediation

Other tasks, duties, projects, and programs assigned

This position may require same-day out-of-office travel 0 - 50% of the time, depending upon the location

This position may require multiple days’ out of town overnight travel 0 - 20% of the time, depending upon location

Qualification

Healthcare experienceQuality improvementCertified Professional in Health Quality (CPHQ)Certified HEDIS Compliance Auditor (CHCA)Business writingExcelVisioData reportingNursing License (RN)

Required

Bachelor's Degree or equivalent combination of education and work experience

Min. 3 years of experience in healthcare with a minimum of 2 years of experience in health plan quality improvement, managed care, or equivalent experience

Demonstrated solid business writing experience

Operational knowledge and experience with Excel and Visio (flow chart equivalent)