AVP, Care Connections Stars & Quality Improvement (REMOTE)

Molina Healthcare

415d • $122,430 - $238,739 • Remote

About The Position

The AVP, Care Connections Stars & Quality Improvement will lead quality initiatives for Molina's Care Connections, focusing on overseeing, planning, and implementing healthcare quality improvement initiatives and education programs to support Medicare Star Ratings improvement. This role involves directing the implementation of improvement strategies, conducting data collection and reporting, and ensuring compliance with quality standards across Medicare Stars and Quality programs.

Requirements

• Bachelor's Degree in a related field (Healthcare Administration, Public Health, or equivalent experience).
• Minimum of 10 years relevant experience, including at least 5 years in health plan quality improvement.
• 5 years Medicaid/Medicare experience.
• Minimum 3 years people management experience.
• Demonstrated knowledge of and experience with Star Rating & Quality Improvement programs.
• Proficiency with data manipulation and interpretation.
• Proficiency with Excel and Visio (flow chart equivalent) and ability to learn new information systems.

Nice To Haves

• CAHPS improvement experience.
• Stars improvement experience.
• State QI experience.
• 3+ years experience in Stars Reporting & Analytics.
• 3+ years health care information systems experience.
• Knowledge of HOS, pay for performance models.
• Experience with clinical intervention concepts and design of quality improvement projects (QIP).
• Advanced QI concepts and basic statistical analysis knowledge.

Responsibilities

• Lead quality initiatives for Molina's Care Connections.
• Oversee and implement healthcare quality improvement initiatives and education programs.
• Plan, develop, and direct improvement strategies for Medicare Stars and Quality programs.
• Conduct data collection, reporting, and monitoring for key performance measurement activities.
• Advise senior management and corporate departments on Medicare Stars & Quality strategies and initiatives.
• Collaborate with senior executives and other departments to set and achieve quality goals.
• Develop strategic direction for Star Rating improvement and program standardization.
• Facilitate activities with other units for intervention development and execution.
• Set direction for Stars program activities and lead corporate Stars initiatives.
• Develop training, goals, and coaching plans for Stars & Quality staff.
• Ensure quality assurance for reports generated by staff.
• Escalate gaps and barriers in implementation and compliance to senior management.
• Represent the Stars department in meetings and discussions about functional areas.
• Identify new QI requirements and build out processes in advance of effective dates.

Benefits

• Competitive benefits and compensation package.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree