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