Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership for Medicare Stars quality improvement (QI) programs and activities. Provides subject matter expertise in planning and implementing QI initiati…
Skills: Medicare Stars Program Management, Quality Improvement, Project Management, Data Analysis, Strategic Thinking
Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership for Medicare Stars quality improvement (QI) programs and activities. Provides subject matter expertise in planning and implementing QI initiati…
Skills: Medicare Stars Program Management, Quality Improvement, Project Management, Data Analysis, Strategic Thinking
Long Beach, California, United States · Remote OK
$49k–$107k/yr
JOB DESCRIPTION Job Summary Provides senior level support for accurate and timely intake and interpretation of regulatory and/or functional requirements related to but not limited to coverage, reimbursement, and processi…
Skills: Regulatory Analysis, Requirement Documentation, Stakeholder Coordination, Business Analysis, Process Improvement
Long Beach, California, United States · Remote OK
$45k–$97k/yr
JOB DESCRIPTION Job Summary Responsible for accurate and timely intake and interpretation of regulatory and/or functional requirements related to but not limited to coverage, reimbursement, and processing functions to su…
Skills: Requirement Analysis, Regulatory Compliance, Stakeholder Coordination, Root Cause Analysis, Problem Management
Long Beach, California, United States · Remote OK
JOB DESCRIPTION Job Summary Leads and directs team responsible for value-based programs (VBP) activities. Responsible for developing and implementing value-based strategies for lines of business impacted by the regulator…
Skills: Value-Based Programs, Risk Adjustment, Contract Design, Managed Care, Medicaid
Long Beach, California, United States · Remote OK
JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to …
Skills: Behavioral Health Assessment, Care Coordination, Case Management, Motivational Interviewing, Care Planning
Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. …
Skills: Program Management, Project Budgeting, Business Requirements Documentation, Process Improvement, Test Planning
Long Beach, California, United States · Remote OK
Job Summary Leads and directs team responsible for multi-state delegation oversight activities including monitoring of delegation oversight to ensure compliance with state, federal, National Committee for Quality Assuran…
Skills: Delegation Oversight, Vendor Management, Compliance Auditing, Risk Monitoring, Strategic Planning
Long Beach, California, United States · Remote OK
Molina Healthcare is hiring for a Sr Data Analyst, Enrollment Research and Data Analytics. This role is a Senior Data Analyst on our Research & Analytics team that supports enrollment operations. We work with member and …
Skills: Sql, Power BI, Ssrs, Azure Databricks, Python
Long Beach, California, United States · Remote OK
$60k–$130k/yr
Molina Healthcare is hiring for a Lead Analyst that will handle Provider and Facility Reimbursements. This team has oversight for all lines of business within our facility reimbursement scope. This team mixes some techni…
Skills: Provider Reimbursement, Facility Reimbursement, Prospective Payment System (PPS), Microsoft Excel, SQL
Long Beach, California, United States · Remote OK
Molina Healthcare of Ohio is hiring for a Sr Quality Improvement/HEDIS Specialist on our Health Plan Community Interventions team. This role is remote however candidates must live in Ohio. This role is laser focused on Q…
Skills: Quality Improvement, HEDIS, QI Science, Power BI, Medicare Stars
Long Beach, California, United States · Hybrid
JOB DESCRIPTION The role typically begins with a training period, during which the employee works closely with a Care Coordinator within their assigned region. Upon completion of training, the employee is provided with a…
Skills: Care Coordination, Comprehensive Assessments, Care Planning, Motivational Interviewing, Medication Reconciliation
Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Provides support to Molina MMISR IT areas through program management, including policy, workflow and process documentation, management of program controls, vendor practices, budgets, governanc…
Skills: Program Management, Project Management, Operational Process Improvement, Managed Care, Microsoft Project
Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Provides support to Molina Vendor Operations through program management, including policy, workflow and process documentation, management of program controls, vendor practices, budgets, govern…
Skills: Program Management, Project Management, Operational Process Improvement, Managed Care, Microsoft Project
Long Beach, California, United States · On-site
Description for Internal Candidates JOB DESCRIPTION ***This role will support hospital providers throughout Florida*** Job Summary Provides support for health plan hospital provider relations activities. Supports network…
Skills: Provider Relations, Network Management, Customer Service, Healthcare Delivery System, Managed Care
Long Beach, California, United States · On-site
JOB DESCRIPTION *****Employee for this role must reside in Florida***** Job Summary Leads and manages team responsible for Hospital Health Plan provider network contracting activities. Supports network strategy and devel…
Skills: Provider Network Contracting, Contract Negotiation, Alternative Payment Models, Value-Based Payment, Capitated Payments
Long Beach, California, United States · Remote OK
$66k–$143k/yr
Job Description Job Summary Provides subject matter expertise in the delivery, execution and maintenance of products. Accountable for maximizing the value of assigned technical products that support enterprise operations…
Skills: Product Ownership, Agile/Scrum, Backlog Management, User Story Writing, Stakeholder Management
Long Beach, California, United States · On-site
$102k–$199k/yr
JOB DESCRIPTION Job Summary Leads and directs team responsible for health plan provider network contracting activities. Supports network strategy and development with respect to adequacy, financial performance and operat…
Skills: Provider Network Contracting, Contract Negotiation, Value-Based Payment Models, Alternative Payment Models, Network Adequacy Management
Long Beach, California, United States · On-site
$66k–$143k/yr
JOB DESCRIPTION Job Summary Responsible for internal business projects and programs involving department or cross-functional teams of subject matter experts, delivering products through the design process to completion. …
Skills: Program Management, Project Budgeting, Scheduling, Vendor Management, Business Requirements Documentation
Long Beach, California, United States · On-site
JOB DESCRIPTION Job Summary Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents he…
Skills: SQL, SSRS, SSIS, Healthcare Analytics, Predictive Modeling
Long Beach, California, United States • On-site
Sign up with Clera and we'll reach out the moment a role actually fits you — no more spraying applications into the void.
Lead and manage Medicare Stars quality improvement programs and initiatives across the enterprise to improve Star ratings. Collaborate with cross-functional teams to design, implement, and measure the outcomes of quality improvement projects.
Requires at least 6 years of experience in Medicare Stars program and project management with strong data analysis and strategic thinking skills. Proficiency in government-sponsored programs and the ability to drive organizational change is essential.
Provides subject matter expertise and leadership for Medicare Stars quality improvement (QI) programs and activities. Provides subject matter expertise in planning and implementing QI initiatives and education programs to support improved Medicare Star ratings. Responsible for leading and managing Medicare Star projects and programs involving enterprise, department, cross-functional and health plan teams of subject matter experts, delivering impactful quality improvement initiatives through design process to completion and outcomes measurement.
Essential Job Duties
Required Qualifications
Preferred Qualifications
• 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.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Molina Healthcare is a FORTUNE 500 company that is focused exclusively on government-sponsored health care programs for families and individuals who qualify for government sponsored health care. Molina Healthcare contracts with state governments and serves as a health plan providing a wide range of quality health care services to families and individuals. Molina Healthcare offers health plans in Arizona, California, Florida, Idaho, Illinois, Kentucky, Massachusetts, Michigan, Mississippi, Nevada, New Mexico, New York, Ohio, South Carolina, Texas, Utah, Virginia, Washington and Wisconsin. Molina also offers a Medicare product and has been selected in several states to participate in duals demonstration projects to manage the care for those eligible for both Medicaid and Medicare.
Offices: 200 Oceangate, Long Beach, California 90802, US
Molina Healthcare is a FORTUNE 500 company that is focused exclusively on government-sponsored health care programs for families and individuals who qualify for government sponsored health care. Molina Healthcare contracts with state governments and serves as a health plan providing a wide range of quality health care services to families and individuals. Molina Healthcare offers health plans in Arizona, California, Florida, Idaho, Illinois, Kentucky, Massachusetts, Michigan, Mississippi, Nevada, New Mexico, New York, Ohio, South Carolina, Texas, Utah, Virginia, Washington and Wisconsin. Molina also offers a Medicare product and has been selected in several states to participate in duals demonstration projects to manage the care for those eligible for both Medicaid and Medicare.
Offices: 200 Oceangate, Long Beach, California 90802, US
