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Program Director, RQS HP Engagement (Remote)
$79,608 - $172,484/Yr
Molina Healthcare
posted about 2 months ago
Full-time - Senior
Remote
Insurance Carriers and Related Activities
About the position
The Program Director, RQS HP Engagement at Molina Healthcare is responsible for managing health plan risk and quality initiatives across multiple state health plans. This role ensures that all action plans are complete, accurate, and aligned with performance goals, while also serving as a subject matter expert in the field. The director will collaborate with various teams to address implementation gaps and support the development of business strategies.
Responsibilities
- Manage 5-7 state health plans utilizing RQS staff with oversight from AVP as needed.
- Supervise one or more Program Managers.
- Serve as an industry subject matter expert in functional areas within RQS and lead programs to meet critical needs.
- Escalate gaps and barriers in implementation and compliance to leadership.
- Partner with the Execution team for resolutions and barrier removal impeding Health Plan execution.
- Support the development of business case methodologies for incremental programs.
- Develop and coordinate the implementation of business strategy.
- Collaborate and facilitate activities with other units at corporate and Molina Plans.
Requirements
- Bachelor's Degree in a Healthcare-related field or equivalent combination of education and experience.
- 7+ years of managed healthcare experience with proven relationship management responsibilities.
- Proven experience in risk adjustment, quality, and provider engagement.
- Demonstrated ability to lead and influence cross-functional teams.
- Excellent communication and presentation skills, able to communicate to all levels within the organization.
- Operational and process improvement experience.
Nice-to-haves
- Master's degree in Business, Health Administration or related field.
- 10+ years of managed care experience specifically within Risk Adjustment and/or Quality.
Benefits
- Competitive benefits and compensation package.
