{"id":327703,"date":"2026-07-19T00:00:00","date_gmt":"2026-07-18T23:00:00","guid":{"rendered":"https:\/\/www.remotetribe.life\/remotejobs\/job\/risk-quality-performance-manager-2\/"},"modified":"2026-07-19T00:00:00","modified_gmt":"2026-07-18T23:00:00","slug":"risk-quality-performance-manager-2","status":"publish","type":"job_listing","link":"https:\/\/www.remotetribe.life\/remotejobs\/job\/risk-quality-performance-manager-2\/","title":{"rendered":"Risk &amp; Quality Performance Manager"},"content":{"rendered":"<p><strong>Job Description<\/strong><\/p>\n<p><strong>Job Summary<\/strong><\/p>\n<p>The Risk &amp; Quality Performance Manager position will support Molina&#8217;s Risk &amp; 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&#8217;s strategic objectives.<\/p>\n<p><strong>Job Duties<\/strong><\/p>\n<p>\u2022\u00a0Collaborate 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.\u00a0<br \/> \u2022\u00a0Monitor projects from inception through successful delivery.<br \/> \u2022\u00a0Oversee Risk\/Quality data ingestion activities and strategies to optimize completeness and accuracy of EHR\/HIE and supplemental data.<br \/> \u2022\u00a0Meet customer expectations and requirements, establish, and maintain effective relationships and gain their trust and respect.<br \/> \u2022\u00a0Draw actionable conclusions, and make decisions as needed while collaborating with other teams.<br \/> \u2022\u00a0Ensure compliance with all regulatory audit guidelines by adhering to roadmap of deliverables and timelines and implementing solutions to maximize national HEDIS audit success.<br \/> \u2022\u00a0Partner with other teams to ensure data quality through sequential transformations and identify opportunities to close quality and risk care gaps.<br \/> \u2022\u00a0Proactively communicate risks and issues to stakeholders and leadership.<br \/> \u2022\u00a0Create, review, and approve program documentation, including plans, reports, and records.<br \/> \u2022\u00a0Ensure documentation is updated and accessible to relevant parties.<br \/> \u2022\u00a0Proactively communicate regular status reports to stakeholders, highlighting progress, risks, and issues.<\/p>\n<p><strong>Job Qualifications<\/strong><\/p>\n<p><strong>REQUIRED EDUCATION:<\/strong><\/p>\n<p>Bachelor&#8217;s degree or equivalent combination of education and experience<\/p>\n<p><strong>REQUIRED EXPERIENCE\/KNOWLEDGE, SKILLS &amp; ABILITIES:<\/strong><\/p>\n<p>\u2022 2+ years of program and\/or project management experience in risk adjustment and\/or quality<br \/> \u2022\u00a02+ years of experience supporting HEDIS engine activity, risk adjustment targeting and reporting systems<br \/> \u2022\u00a02+ years of data analysis experience utilizing technical skillsets and resources to answer nuanced Risk and Quality questions posed from internal and external partners<br \/> \u2022\u00a0Familiarity with running queries in Microsoft Azure or SQL server<br \/> \u2022\u00a0Healthcare experience and functional risk adjustment and\/or quality knowledge<br \/> \u2022\u00a0Mastery of Microsoft Office Suite including Excel and Project<br \/> \u2022\u00a0Experience partnering with various levels of leadership across complex organizations<br \/> \u2022\u00a0Strong quantitative aptitude and problem solving skills<br \/> \u2022\u00a0Intellectual agility and ability to simplify and clearly communicate complex concepts<br \/> \u2022\u00a0Excellent verbal, written and presentation capabilities<br \/> \u2022\u00a0Energetic and collaborative<\/p>\n<p><strong>PREFERRED EDUCATION:<\/strong><\/p>\n<p>Graduate degree or equivalent combination of education and experience<\/p>\n<p><strong>PREFERRED EXPERIENCE:<\/strong><\/p>\n<p>\u2022\u00a0Knowledge of, and familiarity with, NCQA, CMS, and State regulatory submission requirements<br \/> \u2022\u00a0Experience working in a cross-functional, highly matrixed organization<br \/> \u2022\u00a0SQL proficiency<br \/> \u2022\u00a0Knowledge of healthcare claim elements: CPT, CPTII, LOINC, SNOMED, HCPS, NDC, CVX, NPIs, TINs, etc.<br \/><strong>PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:<\/strong><\/p>\n<p>PMP, Six Sigma Green Belt, Six Sigma Black Belt Certification, and\/or comparable coursework desired<\/p>\n<p>#PJCorp<\/p>\n<p>#LI-AC1<\/p>\n<p>To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.<br \/>Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M\/F\/D\/V.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Job Description Job Summary The Risk &amp; Quality Performance Manager position will support Molina&#8217;s Risk &amp; Quality Solutions (RQS) team. 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