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Quality & Value Based Care Program Manger

Bothell, Washington Job ID 2000858
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Job Description

Job Summary
This Program Manager will be responsible for being the subject matter expert in Quality/HEDIS measures and evaluating the quality components of value-based reimbursement models.

Job Responsibilities 

  • In partnership with Provider Network & Contracting, interact with providers and facilitate the negotiation & implementation of quality measures in value based care contracts.
  • Provide direction to assigned Quality Specialists as related to provider relationships and value-based care contracts including preparing for provider meetings and coordinating improvement activities.
  • Manage provider relationships across the network – address issues, develop and provide education and facilitate meeting established goals.
  • Lead and manage process of determining Quality measures performance and final settlement leading to payout.
  • Responsible for partnering with Finance on monthly accruals related to value based care contracts.
  • Responsible for ensuring accurate and timely actionable reports are delivered to providers in collaboration with Quality team and Data analysts.
  • Coordinate with the Directors of Quality and Directors of Contracting & Provider Engagement to develop and implement strategies to achieve targets.



Qualifications

Job Qualifications

Required Education
Bachelor's Degree or equivalent combination of education and experience

Required Experience
5-7 years with good understanding and experience with HEDIS measures 
Progressive experience with business management, negotiation experience, managing projects
People and team management experience preferred

Preferred Education
Graduate Degree or equivalent combination of education and 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.

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