- Leads and collaborates with teams & health plans impacted by Medicare Quality Improvement programs involving enterprise, department or cross-functional teams of subject matter experts, delivering products through the design process to completion.
- Manages, plana and executes Medicare Star Ratings programs. Assigns and monitors work of program management staff providing support and direction.
- Supports Stars program execution and governance needs to communication, measure outcomes and develop initiatives to improve Star Ratings.
- Serves as the Medicare Stars subject matter expert to Program Managers and in functional areas; leads programs to meet critical needs.
- Communicates and collaborates with health plans and Stars measure owners to analyze and transform needs and goals into functional requirements to maximize improvement opportunities
- Leads Health plan leadership discussions to provide recommendations, performance results and opportunity assessments for improvement.
- Works with operational leaders within the business to provide recommendations on opportunities for
- Plans and directs schedules Program initiatives, as well as program budgets.
- Develops, defines, and executes plans, schedules, and deliverables. Monitors programs from initiation
- Monitors and tracks key performance indicators, programs and initiatives to reflect the value and effectiveness of Stars and Quality improvement programs.
-
SAS Programmer- Healthcare Industry
5 days ago
Blue Shield Of California Long Beach, United StatesYour Role · Clinical Quality Analytics team is looking for a Clinical Quality Analytics, Senior who has hands on experience on data analysis, research and programming using SAS from various data sources (flat files, relational databases, other SAS datasets etc.) using Base SAS. ...
-
SAS Programmer- Healthcare Industry
3 weeks ago
Blue Shield of California Long Beach, United StatesYour Role · Clinical Quality Analytics team is looking for a Clinical Quality Analytics, Senior who has hands on experience on data analysis, research and programming using SAS from various data sources (flat files, relational databases, other SAS datasets etc.) using Base SAS. T ...
-
Dir, Medicare Segment Optimization
3 weeks ago
Molina Healthcare Long Beach, United States**Job Description** · **Job Summary** · Molina Segment leaders are responsible for the development and administration of Segment specific departments, programs and services, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance w ...
-
Director, Quality
3 weeks ago
Molina Healthcare Long Beach, United States**Job Description** · **Job Summary** · The Director, Quality & Risk Adjustment is responsible for leading health plan execution for Risk and Quality ensuring alignment of strategy and activities with Enterprise and acting as the Risk and Quality subject matter expert for the hea ...
-
Director, Health Plan Operations
3 weeks ago
Molina Healthcare Long Beach, United States**Job Description** · **Job Summary** · Molina Health Plan Operations jobs are responsible for the development and administration of our State Health Plan's Operational departments, programs and services, in alignment with Molina Healthcare's overall mission, core values, and str ...
-
Community Connector
2 weeks ago
Molina Healthcare Long Beach, United StatesJob Description · Molina Healthcare of Texas is expanding and is hiring for several remote Community Connectors. Candidates for these roles must reside in Texas. · These positions will be making outbound calls to our pregnant and postpartum members to engage and provide any add ...
-
Mgr, Growth
6 days ago
Molina Healthcare Long Beach, United StatesJob Description · Molina Healthcare is hiring a Manager of Growth and Community Engagement in the Riverside or San Bernardino area. · For over 40 years, Molina Healthcare has been a purpose-driven company committed to improving the lives and well-being of our members, while maki ...
-
Clinical Pharmacist Programs
2 weeks ago
SCAN Healthplan Long Beach, United StatesAbout SCAN · SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare Advantage plans, serv ...
-
Clinical Pharmacist Programs
2 weeks ago
HealthCHEC Long Beach, United StatesAbout SCAN · SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare Advantage plans, serv ...
-
SAS Programmer- Healthcare Industry
1 day ago
Blue Shield Of California Long Beach, United StatesYour Role · Clinical Quality Analytics team is looking for a Clinical Quality Analytics, Senior who has hands on experience on data analysis, research and programming using SAS from various data sources (flat files, relational databases, other SAS datasets etc.) using Base SAS. ...
-
Informatics Analyst II
1 week ago
HealthCHEC Long Beach, United StatesAbout SCAN · SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare Advantage plans, ser ...
-
Informatics Analyst II
1 week ago
SCAN Long Beach, United StatesAbout SCAN · SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare Advantage plans, ser ...
-
Dir, Medicare Segment Optimization
1 week ago
Molina Healthcare Long Beach, United StatesJob Description · Job Summary · Molina Segment leaders are responsible for the development and administration of Segment specific departments, programs and services, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all ...
-
Director, Quality
1 week ago
Molina Healthcare Long Beach, United StatesJob Description · Job Summary · Job Duties · Serves as the primary contact to State agencies for all Risk and Quality matters. · Leads the local Quality committees. · Prepares, in collaboration and support with MHI Quality, required documentation for state Performance Improvement ...
-
Staff VP, Carelon Health STARS
3 weeks ago
Elevance Health Cerritos, United States Full timeJob Description · : Location: · Within 50 miles of a PulsePoint, strong preference to Cerritos, CA. · Summary: · Looking to make a monumental impact in healthcare? Our Staff VP Carelon Health Stars acts as the driving force behind the development, coordination, communication, ...
-
Registered Nurse
3 weeks ago
DeSoto Memorial Hospital Arcadia, United States Full timeRegistered Nurse (OR) - Full Time Days. Share Call Rotation. · About this position: · Responsibilities are centralized in provision of patient care. Assumes responsibility for provision of the multidisciplinary progress plan for a specified group of patients for a specified peri ...
-
Product Solutions Manager III
2 weeks ago
L.A. Care Health Plan Los Angeles, United States Full timeJob Summary · The Product Solutions Manager III is responsible for assisting the product leadership team within the Product Strategy, Sales and Marketing (PSSM) service area and the enterprise. The Product Solutions Manager III leads in supporting ongoing operations of the assig ...
-
Patient Care Specialist I
3 days ago
ApolloMed Monterey Park, United StatesAbout the Role · :We are looking for a Patient Care Specialist I to join a team that is passionate about the health of our patients. As part of the Quality Department, the Clinical Operations team leads the effort to improve health outcomes by coordinating and delivering key cli ...
-
Claims Examiner
2 weeks ago
Innovative Management Systems Incorporated Whittier, United States:The Position. · We are looking for a detail-oriented individual that can accurately review, research, and analyze professional claims to determine and calculate the type and level of benefits based on established criteria and provider contracts. Experience in adjudication of Com ...
-
RN - Emergency Nights
3 weeks ago
Providence Venice, United StatesDescription · RN - Emergency at Providence Saint John's Health Center in Santa Monica, CA. Positions available are full-time and will work 12-hour Night shifts. Join our team of clinicians and enjoy excellent an excellent compensation and benefits package. · Providence Saint John ...
Sr Program Manager, Medicare Stars - Long Beach, United States - Molina Healthcare
Description
Job Description
Job Description
Job Summary
Molina Medicare Stars Sr Program Manager function supports program governance, plans, leads and implements quality improvement initiatives and education programs to support improved Star Ratings.
Responsible for Medicare Star projects and programs involving enterprise, department, cross-functional and health plan teams of subject matter experts, delivering impactful initiatives through the design process to completion and outcomes measurement.
Plans and directs schedules as well as program budgets. Monitors the programs and initiatives from inception through delivery. May engage and oversee the work of external vendors. Assigns, directs and monitors system analysis and program staff.These positions' primary focus is project/program management for Stars Program and Quality improvement activities, as week as the application of expertise in a specialized functional field of knowledge.
Job Duties
Job Qualifications
REQUIRED EDUCATION:
Bachelor's Degree or equivalent combination of education and experience
REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:
4-6 years of Medicare Stars Program and project management experience
Demonstrated knowledge of and experience with Star Ratings & Quality Improvement programs
Medicare experience
Excellent presentation and communication skills
Experience partnering with different level of leadership across the organization
PREFERRED EXPERIENCE:
7+ years of Medicare Stars Program experience
PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:
Six Sigma Black Belt Certification, ITIL Certification desired
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.
