Job Description
Job Summary
The Quality Innovations Director is responsible for identifying emerging trends, developing an expanded portfolio of innovative strategies with execution plans attuned to emerging trends and stakeholder needs, identifying, and partnering with key strategic vendors, startups, research groups, etc., championing innovation projects/interventions with business partners and stakeholders, and identifying needed resources related to innovative projects. Key activities include monitoring and analyzing emerging trends in Quality, maintaining an innovation pipeline for RQS and Health Plans to leverage within a comprehensive intervention strategy, actively and persistently ingesting stakeholder input and strategic direction to attune pipeline to Molina’s unique needs, clearly and transparently communicating ROI related to interventions, identifying implementation requirements, performance metrics, and KPIs related to interventions. Serves as the innovation subject matter expert for Risk and Quality Solutions (RQS) and Health Plans.
Job Duties
Identifies innovative Quality interventions that meet state and federal intervention rules and are aligned with effective practices as identified in the healthcare quality improvement literature and within Molina plans.
Develops targeted interventions related to performance improvement, including member and provider outreach to improve care and service. Creates detailed implementation plan.
Serves as operations and implementation liaison for quality improvement interventions using a defined roadmap, timeline, and key performance indicators.
Collaborates with the national analytics and strategic teams to deliver proposed interventions for review and evaluation.
Communicates with senior leadership, national analytics and strategic teams about key deliverables, timelines, barriers, and escalated issues that need immediate attention.
Presents concise summaries, key takeaways, and action steps about plan intervention strategy to national, regional and plan meetings.
Supports business case development for all new, proposed interventions and collaborates with finance on determining ROI to support movement for execution.
Works with key stakeholder panels as part of vetting new interventions to solicit feedback.
Functions as key lead for interventions including qualitative and quantitative analyses, reporting and development of program materials, templates, or policies.
Collaborates and educates network providers to develop effective practice-based quality improvements.
Supports the National Quality Improvement and Health Equity Transformation Workgroup.
Works closely with growth leader to ensure capture of all new interventions in usable format to support growth work.
Job Qualifications
Required Education
Bachelor's Degree in health care field or equivalent work experience.
Required Experience
Minimum 10 years' experience in managed healthcare, including at least 5 years in health plan quality or process improvement or equivalent/related experience.
Minimum 8 years’ experience with member/provider Quality and Risk Adjustment outreach and/or quality intervention or improvement studies (development, implementation, evaluation).
Operational knowledge and experience with Excel, PowerPoint, Word, and Visio.
Demonstrated ability to lead and influence cross-functional teams that oversee implementation of quality interventions.
Possesses a strong knowledge in quality in order to implement effective interventions that drive change.
Excellent communication and presentation skills, communicating to all levels within the organization and external to the organization.
Preferred Education
Master's degree in a Clinical field, Public Health, or Healthcare.
Preferred Experience
8 years' experience with member/ provider Quality and Risk Adjustment outreach and/or quality intervention or improvement studies (development, implementation, evaluation).
Project management and team building experience.
Experience developing performance measures that support business objectives.
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.