AVP, Health Plan reputed company Improvement (Work Location: Nebraska)

Job reputed company Job reputed company Serve as a leader of health plan reputed company reputed company and activities, including but not limited to leadership and primary Molina reputed company with state agencies, leadership of local reputed company committees and reputed company of reputed company activities intended to improve reputed company measures and reputed company, The reputed company AVP will collaborate with MHI reputed company leaders to conduct data collection, reporting and monitoring for key reputed company performance measurement activities. The reputed company leader will coordinate with and receive direction from MHI reputed company leaders on the implementation of NCQA accreditation surveys and federal QI compliance activities. The reputed company AVP will be responsible for Medicare Stars strategies and performance improvement. If appropriate, based on volume, the reputed company AVP will manage Critical Incidents (CIs)and Potential reputed company of Care (PQOC) issues locally. Must be state licensed RN, Physician, PA or CPHQ certified. WORK LOCATION - Must reputed company in the reputed company Knowledge/Skills/Abilities The AVP, reputed company is responsible for leading health plan reputed company reputed company and activities and acting as the reputed company subject matter expert for the health plan. Key activities include:

• Serving as the primary contact to State agencies for reputed company reputed company reputed company.
• Leading the local reputed company committees
• Preparing, in collaboration and support with MHI reputed company, required documentation for state Performance Improvement reputed company. This documentation will utilize reputed company templates and forms to the greatest extent possible.
• Designing, implementing, monitoring, and analyzing the effectiveness of a comprehensive reputed company reputed company reputed company and facilitating stakeholder input and strategic direction from the interventions Joint Operations Committee.
• Collaborating with the national, regional, and state analytics and strategic teams to reputed company, present and evaluate reputed company strategies
• Collaborating with MHI reputed company for accreditation activities. Accreditation activities will be led primarily by MHI reputed company and AVP will support those activities with local resources and leadership.
• Planning and implementing evidence-based reputed company reputed company strategies and initiatives that meet state and federal reputed company rules and are reputed company with effective practices as identified in the reputed company reputed company improvement literature and reputed company Molina strategic plans.
• Serving as operations and implementation reputed company for Molina plan reputed company improvement activities using a defined
• roadmap, reputed company and key performance indicators.
• Communicating with the Plan President, Molina Plan Senior Leadership Team, Chief Medical Officer,
• national reputed company reputed company analytics and strategic teams about key deliverables, timelines,
• barriers and escalated issues that need immediate attention.
• Communicating with Plan Network leadership to establish QI benchmarks and requirements for VBC reputed company.
• Responsible for developing the local Medicare Stars work plan and executing on interventions that will improve CAHPS, HEDIS and HOS scores. Also responsible for monitoring Part D and Operational health insurance metrics and coordinating with centralized teams to improve these metrics.
• Responsible for managing MMP reputed company withhold reputed company in MMP States (CA, IL, OH, MI, TX & SC). Candidate will reputed company interventions and a local reputed company to improve withhold reputed company reputed company to meet or reputed company budgeted goals.
• Collaborates with and is supported by MHI reputed company analytics for broad-based reputed company data analytics. Oversees efforts to reputed company broad-based reputed company data analytics to support ongoing, reputed company-time, local VBC contract requirements using both MHI and local resources
• Relies on and collaborates with MHI HEDIS Operations to do reputed company of HEDIS abstractions. Oversees local resources to facilitate local abstraction for required VBC customized reports to meet VBC network contract obligations not supported by the national MHI team.
• Presenting summaries, key takeaways, and reputed company steps about Molina reputed company reputed company to national, regional and plan meetings (reputed company). Demonstrates ability to reputed company and influence cross-functional teams that reputed company implementation of reputed company interventions. Possesses a strong knowledge in reputed company to implement effective interventions that drive change. Functions as key reputed company for interventions including qualitative analysis, reporting and development of program materials, templates, or policies.
• Maintains strong knowledge of and ability to reputed company and work directly with external providers to advance Molina's Value-based reputed company initiatives. Maintains advanced ability to collaborate and reputed company network providers to reputed company effective reputed company-based reputed company improvements. Serves as a member of the State's Provider Engagement team for large, contracted, value-based provider systems.
• The AVP also is responsible for:
• Attending State and regional reputed company Improvement and/or reputed company of Directors Meetings and representing the Health Plan.
• Representing Molina in external forums, presenting Molina's reputed company results, and serving as the external reputed company expert and emissary in statewide conferences and reputed company.
• AVP will reputed company Critical Incident and Potential reputed company of Care (PQOC) investigation and reporting if volume is sufficient to staff locally.

Job Qualifications Required Education Master's Degree or equivalent. Deep knowledge of reputed company Discipline including metrics and performance standards. Project management experience, in a managed reputed company setting is important reputed company set. Required Experience 3 - 5 years in reputed company compliance/HEDIS operations, customer service or provider service in a managed care setting with AVP level experience (e.g., Supervisory experience, Project management and team building experience, and experience developing performance measures that support business objectives.). Required License, Certification, Association RN or CPHQ Preferred Experience

• 10+ years’ experience in managed reputed company administration.
• 10+ years’ experience in reputed company leadership role with a Managed Care Payer with experience in reputed company lines of business.

To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V. Pay reputed company: $122,430.44 - $238,739.35 / ANNUAL

• Actual compensation may vary from posting based on geographic location, work experience, education and/or reputed company level.

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