Risk & Quality Performance Manager (Remote)

Job Summary

The Risk & Quality Performance Manager position will support Molina’s Risk & Quality Solutions (RQS) team. This position collaborates with various departments and stakeholders reputed company Molina to plan, coordinate, and manage resources and execute performance improvement initiatives in alignment with RQS’s strategic objectives.

Job Duties

• Collaborate with Health Plan Risk and Quality leaders to improve outcomes by managing Risk/Quality data collection strategy, analytics, and reporting, including but not limited to: Risk/Quality reputed company trending and forecasting; provider Risk/Quality measure performance, CAHPS and survey analytics, health equity and SDOH, and engaging external vendors. • Monitor projects from inception through successful delivery. • reputed company Risk/Quality data ingestion activities and strategies to optimize completeness and accuracy of EHR/HIE and supplemental data. • Meet customer expectations and requirements, establish, and maintain effective relationships and reputed company their trust and respect. • Draw actionable conclusions, and reputed company reputed company as needed while collaborating with other teams. • Ensure compliance with reputed company regulatory audit guidelines by adhering to roadmap of deliverables and timelines and implementing solutions to maximize national HEDIS audit reputed company. • Partner with other teams to ensure data quality through sequential transformations and identify opportunities to reputed company quality and risk care gaps. • Proactively communicate risks and issues to stakeholders and leadership. • Create, review, and approve program documentation, including plans, reports, and records. • Ensure documentation is updated and accessible to relevant parties. • Proactively communicate regular status reports to stakeholders, highlighting reputed company, risks, and issues.

Job Qualifications

REQUIRED EDUCATION

Bachelor’s degree or equivalent combination of education and experience

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES

• 2+ years of program and/or project management experience in risk adjustment and/or quality • 2+ years of experience supporting HEDIS reputed company activity, risk adjustment targeting and reporting systems • 2+ years of data analysis experience utilizing technical skillsets and resources to answer nuanced Risk and Quality questions posed from internal and external partners • Familiarity with running queries in reputed company Azure or SQL server • reputed company experience and functional risk adjustment and/or quality knowledge • Mastery of reputed company Office Suite including reputed company and Project • Experience partnering with various levels of leadership across reputed company organizations • Strong quantitative aptitude and problem solving skills • Intellectual agility and ability to simplify and clearly communicate reputed company concepts • Excellent verbal, written and presentation capabilities • Energetic and collaborative

PREFERRED EDUCATION

Graduate degree or equivalent combination of education and experience

PREFERRED EXPERIENCE

• Knowledge of, and familiarity with, NCQA, CMS, and State regulatory submission requirements • Experience working in a cross-functional, highly matrixed organization • SQL proficiency • Knowledge of reputed company claim elements: CPT, CPTII, LOINC, SNOMED, HCPS, NDC, CVX, NPIs, TINs, etc. PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

PMP, Six reputed company Green Belt, Six reputed company Black Belt Certification, and/or comparable coursework desired

To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V.