Program Director, Medicare Stars

Job Description

Job Summary

Molina's Medicare Stars function oversees, plans, and implements new and existing healthcare

quality improvement initiatives and education programs; supporting Medicare Star Ratings improvement. Responsible for planning, developing and directing the implementation of improvement strategies to ensure high level of performance across Medicare Stars and Quality programs. Lead enterprise partnership discussions and improvement opportunities across matrix teams and health plans.

Job Duties

The Program Director is a key Stars & Quality Improvement (QI) leader within the organization, empowered to advise senior management and other departments on Stars/Quality strategies and initiatives.

• Supports Star Program strategy development and ongoing execution for continuous Program improvement and standardization

• Lead Star Program Enterprise governance development and ongoing execution across measure level owners.

• Collaborates and facilitates activities with other units at Corporate and within Molina State Plans for intervention development and execution to support Medicare Stars measure level improvement and program revenue maximization across all key categories of the Stars Program.

• Lead Stars Corporate and Health Plan engagement strategies and discussions in evaluating high performing activities for expansion opportunities

• Provides direction for Stars program activities with department leadership including leading Corporate Stars initiatives that require timely follow-up, tracking and communication on an on-going basis.

• Serves as a Stars subject matter expert and leads programs to meet critical Stars performance targets.

• Communicates with and escalates gaps and barriers in implementation and compliance to department leadership, including proposed resolution.

• Monitors and tracks key quality indicators, programs and initiatives to reflect the value and effectiveness of the Stars and Quality Improvement programs.

Job Qualifications

REQUIRED EDUCATION :

Bachelor's Degree or equivalent combination of education and work experience.

REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES :

• Minimum of 7+ years relevant experience, including at least 5 years in health plan quality

improvement.

• Demonstrated knowledge of and experience with Stars program including in depth knowledge of key Stars categories: HEDIS, Pharmacy, Operations, CAHPS, HOS, Improvement measures.

• 5years Medicare experience

• 3 years management experience

• Operational knowledge and experience with Excel and Visio (flow chart equivalent).

• Proficiency with data manipulation and interpretation.

PREFERRED EDUCATION :

Master's Degree or higher in a clinical field, IT, Public Health or Healthcare Administration.

PREFERRED EXPERIENCE :

• HEDIS reporting or collection experience

• CAHPS improvement experience

• State QI experience

• Stars regulatory Reporting & Analytics

• 3 years' experience in Health Care Industry

• Quality program leadership and direction

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.

Pay Range: $79,607.91 - $172,483.8 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.