Molina Healthcare - Georgetown, KY
posted 2 months ago
The Manager of Clinical Data Acquisition at Molina Healthcare plays a pivotal role in overseeing the quality improvement initiatives and education programs within the organization. This position is responsible for ensuring that healthcare quality standards are maintained for members, which includes conducting data collection, reporting, and monitoring for key performance measurement activities. The manager will also provide direction and implementation of NCQA accreditation surveys and ensure compliance with federal and state quality improvement activities. In this role, the manager will utilize their knowledge and technical expertise to manage the critical processes involved in performance measurement data collection, reporting, and monitoring, particularly focusing on HEDIS and state-based measure reporting. The responsibilities include managing annual HEDIS data collection activities, which involves responding to RFPs, developing HEDIS measures matrix, work plans, and product timelines. The manager will collaborate with various departments within Molina, including Claims, Enrollment, and IT, as well as external auditors and vendors to ensure the accuracy and soundness of the data used to generate HEDIS results. Additionally, the manager will oversee the annual CAHPS survey process and other organizational survey activities, ensuring that quality assurance is performed on generated reports. They will manage medical record review and performance measurement reporting projects, ensuring that timelines are met and that the strategy for HEDIS seasons is effectively defined. The role may also involve implementing improvement activities related to HEDIS and CAHPS processes, coordinating with relevant departments and committees to identify and recommend potential clinical measurement and quality improvement activities. The manager will maximize the use of information from various sources, including claims, pharmacy, and clinical indicators, to submit data to external agencies and quality committees within required timeframes.