Talent.com
Risk & Quality Performance Manager
Risk & Quality Performance ManagerNebraska Staffing • Lincoln, NE, US
Risk & Quality Performance Manager

Risk & Quality Performance Manager

Nebraska Staffing • Lincoln, NE, US
1 day ago
Job type
  • Full-time
Job description

Risk & Quality Performance Manager

The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position collaborates with various departments and stakeholders within Molina to plan, coordinate, and manage resources and execute performance improvement initiatives in alignment with RQS's strategic objectives.

Job Duties :

  • Collaborate with Health Plan Risk and Quality leaders to improve outcomes by managing Risk / Quality data collection strategy, analytics, and reporting, including but not limited to : Risk / Quality rate trending and forecasting; provider Risk / Quality measure performance, CAHPS and survey analytics, health equity and SDOH, and engaging external vendors.
  • Monitor projects from inception through successful delivery.
  • Oversee Risk / Quality data ingestion activities and strategies to optimize completeness and accuracy of EHR / HIE and supplemental data.
  • Meet customer expectations and requirements, establish, and maintain effective relationships and gain their trust and respect.
  • Draw actionable conclusions, and make decisions as needed while collaborating with other teams.
  • Ensure compliance with all regulatory audit guidelines by adhering to roadmap of deliverables and timelines and implementing solutions to maximize national HEDIS audit success.
  • Partner with other teams to ensure data quality through sequential transformations and identify opportunities to close quality and risk care gaps.
  • Proactively communicate risks and issues to stakeholders and leadership.
  • Create, review, and approve program documentation, including plans, reports, and records.
  • Ensure documentation is updated and accessible to relevant parties.
  • Proactively communicate regular status reports to stakeholders, highlighting progress, risks, and issues.

Job Qualifications : Required Education :

  • Bachelor's degree or equivalent combination of education and experience.
  • Required Experience / Knowledge, Skills & Abilities :

  • 2+ years of program and / or project management experience in risk adjustment and / or quality.
  • 2+ years of experience supporting HEDIS engine activity, risk adjustment targeting and reporting systems.
  • 2+ years of data analysis experience utilizing technical skillsets and resources to answer nuanced Risk and Quality questions posed from internal and external partners.
  • Familiarity with running queries in Microsoft Azure or SQL server.
  • Healthcare experience and functional risk adjustment and / or quality knowledge.
  • Mastery of Microsoft Office Suite including Excel and Project.
  • Experience partnering with various levels of leadership across complex organizations.
  • Strong quantitative aptitude and problem solving skills.
  • Intellectual agility and ability to simplify and clearly communicate complex concepts.
  • Excellent verbal, written and presentation capabilities.
  • Energetic and collaborative.
  • Preferred Education :

  • Graduate degree or equivalent combination of education and experience.
  • Preferred Experience :

  • Knowledge of, and familiarity with, NCQA, CMS, and State regulatory submission requirements.
  • Experience working in a cross-functional, highly matrixed organization.
  • SQL proficiency.
  • Knowledge of healthcare claim elements : CPT, CPTII, LOINC, SNOMED, HCPS, NDC, CVX, NPIs, TINs, etc.
  • Preferred License, Certification, Association :

  • PMP, Six Sigma Green Belt, Six Sigma Black Belt Certification, and / or comparable coursework 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. Pay Range : $77,969 - $155,508 / ANNUAL

  • Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.
  • Create a job alert for this search

    Performance Manager • Lincoln, NE, US

    Related jobs
    Restaurant Delivery - Flexible Onboarding

    Restaurant Delivery - Flexible Onboarding

    DoorDash • Crete, NE, United States
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show more
    Last updated: 1 day ago • Promoted
    Delivery Driver - Sign Up in Minutes

    Delivery Driver - Sign Up in Minutes

    DoorDash • Syracuse, NE, United States
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show more
    Last updated: 30+ days ago • Promoted
    Delivery Driver - Receive 100% of Customer Tips

    Delivery Driver - Receive 100% of Customer Tips

    DoorDash • Seward, NE, United States
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show more
    Last updated: 1 day ago • Promoted
    Restaurant Delivery - Be Your Own Boss

    Restaurant Delivery - Be Your Own Boss

    DoorDash • Seward, NE, United States
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show more
    Last updated: 1 day ago • Promoted
    Quality Assurance and Training Manager

    Quality Assurance and Training Manager

    Nebraska Staffing • Lincoln, NE, US
    Full-time
    Our Company ResCare Community Living Overview The Quality Assurance Manager (QAM) position is focused on maintaining local compliance with State, Federal and BrightSpring Health requirements.The QA...Show more
    Last updated: 1 day ago • Promoted
    Restaurant Delivery - Sign Up and Start Earning

    Restaurant Delivery - Sign Up and Start Earning

    DoorDash • Syracuse, NE, United States
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show more
    Last updated: 30+ days ago • Promoted
    Restaurant Delivery

    Restaurant Delivery

    DoorDash • Seward, NE, United States
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show more
    Last updated: 1 day ago • Promoted
    Restaurant Delivery - Flexible Schedule

    Restaurant Delivery - Flexible Schedule

    DoorDash • Seward, NE, United States
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show more
    Last updated: 1 day ago • Promoted
    Senior Manager, Technology Risk

    Senior Manager, Technology Risk

    Nebraska Staffing • Lincoln, NE, US
    Full-time
    Senior Manager For Technology Risk.Ready to be pushed beyond what you think you're capable of? At Coinbase, our mission is to increase economic freedom in the world. It's a massive, ambitious opport...Show more
    Last updated: 1 day ago • Promoted
    Restaurant Delivery - Receive 100% of Customer Tips

    Restaurant Delivery - Receive 100% of Customer Tips

    DoorDash • Crete, NE, United States
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show more
    Last updated: 1 day ago • Promoted
    Drive with DoorDash - Receive 100% of Customer Tips

    Drive with DoorDash - Receive 100% of Customer Tips

    DoorDash • Seward, NE, United States
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show more
    Last updated: 1 day ago • Promoted
    Restaurant Delivery - Start Earning Quickly

    Restaurant Delivery - Start Earning Quickly

    DoorDash • Crete, NE, United States
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show more
    Last updated: 1 day ago • Promoted
    Risk Manager

    Risk Manager

    Nebraska Staffing • Lincoln, NE, US
    Full-time
    Ready to be pushed beyond what you think you're capable of? At Coinbase, our mission is to increase economic freedom in the world. It's a massive, ambitious opportunity that demands the best of us, ...Show more
    Last updated: 1 day ago • Promoted
    Delivery Driver - Flexible Onboarding

    Delivery Driver - Flexible Onboarding

    DoorDash • Seward, NE, United States
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show more
    Last updated: 1 day ago • Promoted
    Restaurant Delivery - Sign Up in Minutes

    Restaurant Delivery - Sign Up in Minutes

    DoorDash • Beatrice, NE, United States
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show more
    Last updated: 1 day ago • Promoted
    Risk & Quality Performance Manager (Remote)

    Risk & Quality Performance Manager (Remote)

    Nebraska Staffing • Lincoln, NE, US
    Remote
    Full-time
    Risk & Quality Performance Manager.The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position collaborates with various departments and ...Show more
    Last updated: 1 day ago • Promoted
    Quality Assurance and Training Manager

    Quality Assurance and Training Manager

    BrightSpring Health Services • Lincoln, NE, US
    Full-time
    The Quality Assurance Manager (QAM) position is focused on maintaining local compliance with State, Federal and BrightSpring Health requirements. The QAM provides leadership oversight to operations ...Show more
    Last updated: 30+ days ago • Promoted
    Quality Systems Manager

    Quality Systems Manager

    Koch Industries • Lincoln, NE, US
    Full-time
    The Quality Systems and Customer Quality Manager is responsible for developing, implementing, and maintaining quality management systems in compliance with applicable standards (e.This role also se...Show more
    Last updated: 30+ days ago • Promoted