Job SummaryThe AVP, Stars & Quality Improvement will lead quality initiateives for Molina's Care Connections (https://www.molinahealthcare.com/members/common/care-conn.aspx) .Molina’s Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; supporting Medicare Star Ratings improvement. Responsible for planning, developing and directing the implementation of improvement strategies to ensure high level of performance across Medicare Stars and Quality programs. Leads enterprise partnership discussions and improvement opportunities across matrix teams and health plans. This role is responsible for ensuring 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 key Stars strategies to support program regulations.Job DutiesThe Associate Vice President is a key Stars & Quality Improvement (QI) leader within the organization enterprise-wide. This position advises senior management, other corporate departments, and Molina health plans on Medicare Stars & Quality strategies and initiatives and performs oversight over critical Medicare Stars functions enterprise-wide. These functions include, but may not be limited to: Stars Reporting, Performance Measurement, Clinical & Quality Interventions, and Stars Compliance.
Works with senior executives, Vice Presidents and others across Molina Healthcare (within Molina Plans and within various corporate departments) to set and achieve quality goals.
Develops strategic direction for Star Rating improvement through ongoing execution and program standardization.
Collaborates and facilitates activities with other units at Corporate and within Molina State plans for intervention development and execution to support Medicare Stars measure level improvement and program revenue maximization across all key categories of the Stars Program
Sets direction for Stars program activities with department leadership including leading corporate Stars initiative that require timely follow-up, tracking and communication on an on-going basis.
Develops training, goals and coaching plans for Stars & Quality staff.
Ensures that quality assurance is performed for all reports generated by staff reporting to this position. Examples include reports for Senior Leadership Teams, performance measurement tracking, and medical record review completion status.
Escalates gaps and barriers in implementation and compliance to VP, Quality and other senior management as appropriate.
Serves as a subject matter expert and represents the Stars department in meetings and discussions about functional area.
Collaborates and facilitates activities with other units at corporate and Molina Plans.
Identifies new QI requirements and builds out processes in advance of effective dates
Job QualificationsREQUIRED EDUCATION :Bachelor's Degree in a related field (Healthcare Administration, Public Health, or equivalent experience.REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES :
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 demonstrated ability to learn new information systems and software programs.
PREFERRED EXPERIENCE :
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, design of quality improvement projects (QIP), advanced QI concepts, identification of target and subset populations, and basic statistical analysis and significance concepts.
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.Pay Range: $122,430.44 - $238,739.35 / ANNUALActual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
