Program Manager, Medicare Stars & Quality Improvement (Remote)

Molina Healthcare•United States,

2h•$65,792 - $142,549•Remote

About The Position

Provides subject matter expertise and leadership for Medicare Stars quality improvement (QI) programs and activities. Plans and implements QI initiatives and education programs to support improved Medicare Star ratings. Leads and manages Medicare Star projects and programs involving enterprise, department, cross-functional, and health plan subject matter experts, delivering quality improvement initiatives from design through completion and outcomes measurement.

Requirements

At least 6 years of Medicare Stars program and project management experience, or an equivalent combination of relevant education and experience.
Demonstrated knowledge of and experience with Medicare Star ratings and QI programs.
Advanced knowledge of the quality discipline, including metrics and performance standards.
Experience with government-sponsored programs such as Medicaid, Medicare, or Marketplace.
Experience developing performance measures that support business objectives.
Solid business writing experience.
Strong strategic-thinking skills.
Strong proficiency in data analysis, manipulation, interpretation, reporting, and data-driven decision-making.
Critical-thinking, problem-solving, and analytical skills.
Attention to detail and organizational skills.
Ability to implement process improvement initiatives and drive change.
Ability to work independently in a fast-paced, deadline-driven environment.
Ability to work in a cross-functional, highly matrixed organization.
Strong project management experience.
Excellent verbal, written, and presentation communication skills.
Proficiency with Microsoft Office, including Excel, and applicable software programs, with the ability to learn new information systems and software programs.

Nice To Haves

Strong Medicare Stars/quality improvement (QI) program experience.
Six Sigma Black Belt Certification.
ITIL (Information Technology Infrastructure Library) certification.
Experience leading significant cross-functional work.
Strong project management experience.

Responsibilities

Collaborate with corporate and health plan teams to develop and implement enterprise Medicare Stars QI programs and initiatives.
Manage, plan, and execute Medicare Star ratings programs.
Support Stars program execution and governance, communicate and measure outcomes, and develop initiatives to improve Star ratings.
Serve as the Medicare Stars subject matter expert for corporate functional areas and health plans, and lead programs to meet critical needs.
Work with health plans and Stars measure owners to analyze needs and goals and translate them into functional requirements that maximize improvement opportunities.
Lead health plan leadership discussions, providing recommendations, performance results, and opportunity assessments for Medicare Stars improvement.
Work with business operational leaders to recommend opportunities for process improvement, organizational change management, program management, and other processes related to Medicare Star ratings.
Facilitate process improvement, organizational change management, program management, and other processes related to the Medicare Stars Program.
Plan and direct schedules and budgets for program initiatives.
Develop and execute plans, schedules, and deliverables; monitor programs from initiation through delivery and outcomes measurement.
Monitor and track KPIs, programs, and initiatives to reflect the value and effectiveness of Stars and QI programs.
Create business requirements documents, test plans, requirements traceability matrices, user training materials, and related documents.
Monitor projects from inception through delivery and outcomes measurement.
May engage and oversee external vendors.
Generate and distribute Medicare Stars and quality improvement standard reports in a timely manner.