Manager, Clinical Data Acquisition (Remote)

$87,722 - $171,058/Yr

Molina Healthcare

Full-time - Manager

Remote

Insurance Carriers and Related Activities

About the position

The Manager, Clinical Data Acquisition at Molina Healthcare is responsible for overseeing the performance measurement data collection, reporting, and monitoring processes, including HEDIS and state-based measure reporting. This role involves managing annual HEDIS data collection activities, ensuring quality assurance for generated reports, and coordinating with various departments and external vendors to ensure the accuracy and soundness of data used for performance measurement. The position also includes implementing improvement activities related to HEDIS and CAHPS processes and submitting data to external agencies and quality committees.

Responsibilities

• Manage annual HEDIS data collection activities, including responding to RFPs and developing HEDIS measures matrix and work plans.
• Coordinate with internal and external stakeholders to manage contracts and projects related to data collection and reporting.
• Ensure the soundness and correctness of data used to create HEDIS results and manage the state's annual CAHPS survey process.
• Perform quality assurance for generated reports, ensuring performance measurement rates are accurate.
• Manage medical record review and performance measurement reporting projects, ensuring timelines are met.
• Implement improvement activities related to HEDIS and CAHPS processes, coordinating with appropriate departments and committees.
• Maximize the use of information from multiple sources for performance measurement and quality improvement activities.
• Submit data to external agencies and quality committees within required timeframes.

Requirements

• Bachelor's Degree or equivalent work experience.
• 7+ years experience in managed healthcare Quality/HEDIS project management and HEDIS Audit.
• Demonstrated knowledge of and experience with HEDIS programs.
• Proficiency with data manipulation and interpretation.
• Proficiency with Excel and Visio, with the ability to learn new information systems and software programs.

Nice-to-haves

• Master's Degree or higher in a clinical field, Public Health or Healthcare.
• STARS improvement experience.
• CAHPS improvement experience.
• 3+ years health care information systems experience or in a role as an IS liaison/contact for QI projects.
• State QI experience.
• Supervisory experience.
• Project management and team building experience.
• Experience developing performance measures that support business objectives.
• Certified Professional in Health Quality (CPHQ)

Benefits

• Competitive benefits and compensation package.