Senior Specialist, Quality Program Management
4 weeks ago
Senior Specialist, Quality Program Management And PerformanceThe Senior Specialist, Quality Program Management and Performance implements new and existing healthcare quality improvement activities to maintain compliance with quality program requirements and reporting and monitoring for key quality program activities. Acts as a lead specialist to provide project, program, and/or initiative related direction. Provides guidance for other specialists within the department and/or collaboratively with other departments to ensure quality programs meet regulatory requirements.Job Duties: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 requirementsImplements 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 wayOversees quality program management activities, which include preparation for quality improvement audits, surveys, and other federal and state-required quality activitiesMonitors 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 neededWrites narrative reports and works with departmental specialists (as appropriate) to interpret regulatory specifications, explain programs and results of programs, and document findingsMaintains quality program management project plan to ensure state (and/or federal and NCQA-related) requirements are documented during the yearWorks 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 teamsCreates, manages, and/or compiles the required documentation to maintain critical quality improvement functionsLeads quality improvement activities, meetings, and discussions with and between other departments within the organizationEvaluates project/program activities and results to identify opportunities for improvementSurfaces to the Manager and/or Director any gaps in processes that may require remediationOther tasks, duties, projects, and programs assignedThis position may require same-day out-of-office travel 0 - 50% of the time, depending upon the locationThis position may require multiple days' out of town overnight travel 0 - 20% of the time, depending upon locationJob Qualifications:Required Qualifications:Bachelor's Degree or equivalent combination of education and work experienceMin. 3 years of experience in healthcare with a minimum of 2 years of experience in health plan quality improvement, managed care, or equivalent experienceDemonstrated solid business writing experienceOperational knowledge and experience with Excel and Visio (flow chart equivalent)Preferred Qualifications:Degree in Preferred field: Clinical Quality, Public Health, or Healthcare5 years of experience in health plan quality managementExperience with data reporting, analysis, and/or interpretationActive, unrestricted Certified Professional in Health Quality (CPHQ)Active, unrestricted Nursing License (RN may be preferred for specific roles)Active, unrestricted Certified HEDIS Compliance Auditor (CHCA)Molina Healthcare offers a competitive benefits and compensation package Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/VPay Range: $52,176 - $107,098 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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