Molina Healthcare, inc

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Mgr, Quality

at Molina Healthcare, inc

Posted: 2/8/2019
Job Reference #: 1807153

Job Description

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Job Description


Job Summary
Responsible for planning, developing and directing the implementation of techniques to ensure the maintenance of performance and quality levels in the Business' products and processes. Reviews product designs and establishes procedures and techniques for the control of quality standards. Directs inspection services in coordination with engineering groups.

Knowledge/Skills/Abilities
• Maintains smooth functioning of Quality units, coordinates administrative workflow of the departments and develops new processes as needed.
• Serves as local contact for HR on matters pertaining to employee benefits, to administrate hiring, including working with recruiters, reviewing resumes, setting-up and participating in interviews. Arranges for system access and equipment, assists in training and documentation for new hires and terminations.
• Serves as local contact for Finance – assisting with administration; facilitating a large percentage of invoices for Quality Department, including outside vendors.
• For Payroll, serves as local contact – responsible for Quality departments' payroll; supervise timekeeping; oversee vacation scheduling; record keeping in Kronos system.
• For Facilities, serves as local contact (building maintenance, administration, vendors, property management), IT/Information Services, Procurement, Business Development, and state health plans
Supervises staff who have the responsibility for the implementation of HEDIS activities, including the identification, collection and abstraction of medical records and other data in support of annual HEDIS project management and ongoing review of medical records submitted by providers.
• Implements Molina Healthcare goals and / or oversees local processes for HEDIS and / or Quality Reporting.
• Participates in meetings with the corporate HEDIS team, vendors and / or HEDIS auditors. Works with QI management to provide medical record vendor oversight.
• Provides data collection and / or report development support for Quality Improvement studies and performance improvement project.
• Ensures all data-intensive HEDIS and / or reporting activities are accomplished timely and accurately.
• Identifies and oversees new supplemental data sources for use in HEDIS reporting.
• Coordinates HEDIS and QI related projects to meet customers' expectations.
• Ensures standard rate validations are completed in conjunction with reporting.
• Works with other Health Plan and / or Corporate departments (e.g., Risk Adjustment) to ensure prospective and / or retrospective chart reviews and completed timely and accurately.
• Effectively oversees internal and / or external vendor communications by collaborating and disseminating reports, defining program descriptions, and / or sharing analytical findings.
 


Qualifications

Job Qualifications



Required Education
Bachelor's Degree or equivalent combination of education and experience
Required Experience
5-7 years
Preferred Education
Bachelor's degree in Business Management/Health Care Management or equivalent experience.
Preferred Experience
7-9 years

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.