Job Description

Job Summary

Responsible for planning, developing, and directing the implementation of strategies to ensure high levels of performance and quality within the established quality improvement processes and programs across all business segments. Reviews and conducts on-going evaluation of quality improvement programs and interventions to assess effectiveness and to direct business decisions and investments into impactful quality improvement activities. Collaborates and communicates effectively with senior leadership and management to direct effective and efficient programs that produce positive results.

Job Duties

• Develops and deploys strategy to ensures implementation of strategic and standardized quality programs to achieve maximum performance and quality initiatives in all markets and products (within Molina Plans and/or within corporate departments) that drive goal achievement.

• Provides oversight of State Plan quality measure performance within all segments and effectively provides performance oversight, feedback, direction and recommended strategies (including identification of challenges) to Molina Plan and/or Corporate leadership.

• Oversees Quality performance of all segments in conjunction with Molina Plan and/or corporate quality-related activities, including but not limited to: performance measurement operations, quality improvement compliance, credentialing (as applicable), and clinical interventions.

• Identifies and sources effective solutions (“Best Practices”) for improving performance from within the health plan industry and from within Molina and incorporates these effective practices into the comprehensive programs.

• Communicates effectively and concisely (through written documentation and verbal presentations), the status of quality performance and quality program effectiveness, program direction, including existing and planned activities, and/or recommendations for change to external stakeholders, including local and national governmental agencies to ensure compliance and better understanding.

• Works closely with RQS leaders to ensure alignment of activities across RQS and in support of growth efforts and needs to win or retain business.

Job Qualifications

REQUIRED EDUCATION :

Master’s degree in related field or equivalent combination of education and experience.

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES :

• 8+ years in quality improvement, including 6+ years in managed care.

• Minimum 3 years people leadership experience.

• Excellent verbal and written communication skills.

• Ability to influence and drive change among peers and others within the Molina organization, internal and external customers.

• Executive presence with strong communication skills and ability to present to executive leadership.

PREFERRED EXPERIENCE :

• 6+ years with operational experience leading Quality Improvement programs/department within an established health plan and development of policy statements and comments related to quality.

• HEDIS audit, data flow and measures.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

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

Pay Range: $122,430.44 - $238,739.35 / ANNUAL

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