Director, Health Plan Quality Interventions, Columbus, OH
Molina's Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; ensures maintenance of programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement activities; and provides direction and implementation of NCQA accreditation surveys and federal/state QI compliance activities.
The Director, Health Plan Quality Interventions will be responsible for implementing quality improvement interventions and acting as the subject matter expert for the health plan. Key activities include implementing, monitoring and analyzing the effectiveness of a comprehensive intervention strategy and facilitating stakeholder input and strategic direction from the interventions Joint Operations Committee that includes leadership from multi-functional areas. You will represent the senior leadership team at internal Molina national and regional meetings, serves as the subject matter expert for the health plan at state meetings and actively oversees the completion of effective Performance Improvement Projects, as well as serve as the primary contact for health plan interventions and leads the interventions Joint Operations Committee, representing the Molina Plan Senior Leadership Team. In all activities,you will collaborate with the national and regional analytics and strategic teams to present and evaluate intervention strategies.
What you will do...
- Plans and/or implements Quality interventions that meet state and federal intervention rules and are aligned with effective practices as identified in the healthcare quality improvement literature and within Molina plans.
- Develops and implements targeted interventions related to performance improvement, including member and provider outreach to improve care and service.
- Serves as operations and implementation lead for Molina Plan quality improvement interventions using defined roadmaps, timelines and key performance indicators.
- Collaborates with the national intervention collaborative analytics and strategic teams to deliver proposed interventions for review and evaluation.
- Communicates with the Molina Plan Senior Leadership Team, including the Plan President, Chief Medical Officer, national intervention collaborative analytics and strategic teams about key deliverables, timelines, barriers and escalated issues that need immediate attention.
- Presents concise summaries, key takeaways and action steps about Molina plan intervention strategy to national, regional and plan meetings.
- Demonstrates ability to lead and influence cross-functional teams that oversee implementation of quality interventions.
- Possesses a strong knowledge in quality in order to implement effective interventions that drive change.
- Functions as key lead for interventions including qualitative analysis, reporting and development of program materials, templates or policies.
- Maintains advanced ability to collaborate and educate network providers to develop effective practice-based quality improvements.
Bachelor's Degree or Master's Degree in health care field with process improvement work experience.
- At least 5-8 years' experience in managed healthcare, including at least 4 years in health plan quality or process improvement or equivalent/related experience.
- Operational knowledge and experience with Excel and Visio (flow chart equivalent).
Master's Degree or higher in a clinical field, Public Health or Healthcare.
- 3+ years' experience with member/ provider (HEDIS) outreach and/or quality intervention or improvement studies (development, implementation, evaluation) and Director level experience.
- Supervisory experience.
- Project management and team building experience.
- Experience developing performance measures that support business objectives.
Preferred License, Certification, Association
- Certified Professional in Health Quality (CPHQ)
- Nursing License (RN may be preferred for specific roles)
- Certified HEDIS Compliance Auditor (CHCA)
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.