Job Details

Quality Program Management And Performance Specialist

The 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. Provides support for projects, programs, and/or initiatives within the department and/or collaboratively with other departments to ensure quality programs meet regulatory requirements.

Job Duties

• Conducts quality program management activities in compliance with state (and federal and NCQA requirements, as appropriate)
• Monitors and ensures that key quality activities are completed on time and accurately to present results to key departmental management and other Molina departments as needed to meet regulatory requirements
• Writes (and/or reviews) narrative reports to interpret regulatory specifications, explain programs and results of programs, and document findings and limitations of department interventions
• Creates, manages, and/or compiles the required documentation to maintain critical quality improvement functions
• Participates in quality improvement activities, meetings, and discussions with and between other departments within the organization
• Surfaces to the Manager and/or Director any gaps in processes that may require remediation
• Communicates clearly and concisely and is able to tailor messaging to diverse audiences
• Demonstrates flexibility when it comes to changes and maintains a positive outlook
• Performs other tasks, duties, projects, and programs as assigned
• This position may require same-day out-of-office travel approximately 0 - 50% of the time, depending on the location
• This position may require multiple day out of town overnight travel approximately 0 - 20% of the time, depending upon location

Job Qualifications

REQUIRED QUALIFICATIONS:

• Bachelor's Degree or equivalent combination of education and work experience
• Min. 2-3 years of experience in healthcare with 1-year 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)

PREFERRED QUALIFICATIONS:

• Degree in Preferred field: Nursing, Clinical Quality, Public Health, or Healthcare Administration
• Active, unrestricted Certified Professional in Health Quality (CPHQ)
• Active, unrestricted Nursing License (RN may be preferred for specific roles)