Note: The job is a remote job and is open to candidates in USA. Molina Healthcare is a leading provider in the healthcare sector, and they are seeking a Program Manager for Medicare Stars & Quality Improvement. This role involves providing expertise and leadership for Medicare Stars quality improvement programs, managing projects, and collaborating with various teams to enhance Medicare Star ratings.
Responsibilities
- Collaborates with cross-functional corporate and health plan teams on the development and implementation of enterprise Medicare Stars quality improvement (QI) programs and initiatives across the enterprise
- Manages, plans and executes Medicare Star ratings programs
- Supports Stars program execution and governance needs; communicates, measures outcomes and develops initiatives to improve Star ratings
- Serves as the Medicare Stars subject matter expert to corporate functional areas/health plans, and leads programs to meet critical needs
- Communicates and collaborates with health plans and Stars measure owners to analyze and transform needs and goals into functional requirements to maximize improvement opportunities
- Leads health plan leadership discussions to provide recommendations, performance results and opportunity assessments for Medicare Stars improvement
- Collaborates with operational leaders within the business to provide recommendations on opportunities for process improvements, organizational change management, program management and other processes related to Medicare Star ratings
- Facilitates process improvement, organizational change management, program management and other processes relative to the Medicare Stars Program
- Plans and directs schedules for program initiatives, as well as program budgets
- Develops, defines, and executes plans, schedules, and deliverables; monitors programs from initiation through delivery through outcomes measurement
- Monitors and tracks key performance indicators (KPIs), programs and initiatives to reflect the value and effectiveness of Stars and QI programs
- Creates business requirements documents, test plans, requirements traceability matrix, user training materials and other related documents
- Monitors projects from inception through delivery and outcomes measurement
- May engage and oversee the work of external vendors
- Generates and distributes quality improvement/Medicare Stars standard reports timely
Skills
- At least 6 years of Medicare Stars program and project management experience, or 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 (Medicaid, Medicare, Marketplace)
- Experience developing performance measures that support business objectives
- Solid business writing experience
- Strong strategic-thinking skills
- Strong proficiency with 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
- Microsoft Office suite (including Excel), and applicable software programs proficiency, and ability to learn new information systems and software programs
- Strong Medicare Stars/quality improvement (QI) program experience
- Six Sigma Black Belt Certification
- ITIL (Information Technology Infrastructure Library) certification
- Experience in leading significant cross-functional work
- Strong project management experience
Benefits
- Molina Healthcare offers a competitive benefits and compensation package.
Company Overview
Company H1B Sponsorship