Director, National Clinical Data Acquisition- Supplemental Data (Remote)

Leads and directs team responsible for Molina enterprise clinical data acquisition activities. Responsible for implementing, monitoring, and overseeing chart collection for Healthcare Effectiveness Data and Information Set (HEDIS), and HEDIS-like projects, risk adjustment, risk adjustment data validation, and other state-specific audit projects and deliverables. Collaborates with health plan quality leads to strategically plan for supplemental data source (SDS) acquisition from providers and Electronic Medical Record (EMR) access. Oversees HEDIS-related training, vendor chart collection, invoice efforts, and SDS and EMR implementations.

This position works with supplemental data. Please update your resume with any relevant experience.

Essential Job Duties

• Plans and/or implements operational processes for HEDIS operations that meet state and federal reporting requirements/rules, aligned with effective practices as identified in health care quality improvement literature and Molina health plans.
• Develops and implements targeted collection of clinical data acquisition related to performance reporting and improvement, including member and provider outreach.
• Serves as a subject matter expert (SME) for Molina health plan quality improvement HEDIS operations using a defined roadmap, timeline and key performance indicators (KPIs).
• Collaborates with the national intervention collaborative analytics and strategic teams to deliver value for both prospective and retrospective programs.
• Communicates with health plan senior leadership teams, national intervention teams and strategic teams on key deliverables, timelines, barriers and escalated issues that need immediate attention.
• Presents concise summaries, key takeaways and action steps related to Molina HEDIS processes, strategy and progress at national, regional and plan meetings.
• Demonstrates ability to lead and influence cross-functional teams that oversee implementation of quality p