Director, Clinical Performance Oversight

JOB DESCRIPTION Job Summary Leads and directs a team supporting clinical performance improvement activities. Responsible for continuous improvement and successful execution of clinical transformation, and performance and process improvement initiatives. Strives toward desired operational efficiencies, and provides intensive and immersive hands-on coaching and support - ensuring full optimization of business capabilities. Participates with senior leadership to establish strategic plans and objectives. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties u2022 Under the direction of clinical operations leadership, responsible for oversight of internal and external clinical program performance at Molina. u2022 Monitors performance of assigned clinical programs during each phase of program lifecycle. u2022 Proactively identifies improvement opportunities, manages process gaps and identifies and implements solutions with alignment from key stakeholders. u2022 Uses data to evaluate actual to expected program performance. u2022 Synthesizes and presents learnings, insights and recommendations for key stakeholders and executive leadership. u2022 Uses analytical skills to identify variances in expected clinical program performance, and uses problem-solving skills and business knowledge to make recommendations for process remediation or improvement. u2022 Utilizes a variety of complex clinical and financial data points to inform recommendations. u2022 Organizes and structures cross-functional teams to drive complex programs across both shared functions and market operations. u2022 Develops, performs and promotes interdepartmental integration and collaboration to enhance clinical services. u2022 Collaborates with and keeps clinical leadership within healthcare services informed of operational issues, staffing, resources, system and program needs, and presents solution action plans for issues identified. u2022 Drives process change by integrating new processes with existing ones through direct coaching and mentoring of impacted business teams. u2022 Conducts real-time technology and operational walk-throughs as an immersive coaching clinical subject matter expert, and provides interim stabilization support. u2022 Assesses business and operational needs for opportunities to improve efficiency, productivity, effectiveness and accuracy. u2022 Drives process change by integrating new processes with existing ones, and communicating these changes to impacted business teams. u2022 Uses understanding of key revenue levers, cost drivers and customer satisfaction impacts of business processes to optimize and improve business processes and productivity. u2022 Evaluates and modifies existing oversight programs/criteria to meet ongoing business requirements. u2022 Provides oversight in the designs and implementation of programs to build/improve positive relationship with vendors. u2022 Provides oversight, coaching, training and support to team of direct reports. Required Qualifications u2022 At least 8 years health care experience, including 6 years of managed care experience supporting clinical operations and clinical/quality improvement activities, or equivalent combination of relevant education and experience. u2022 At least 3 years health care management/leadership experience. u2022 Registered Nurse (RN) or other advanced clinical or medical licensure. License must be active and unrestricted in state of practice. u2022 Deep understanding of clinical operations: utilization management, care management, etc. u2022 Ability to provide hands-on, immersive and directed support for identified business improvement initiatives. u2022 Ability to work cross-collaboratively in a highly matrixed environment. u2022 Experience providing coaching, development and operational feedback to individuals and teams. u2022 Experience using business knowledge to make recommendations for process remediation or improvement. u2022 Strong ability to lead and achieve results. u2022 Strong interpersonal, consultative, organizational, tracking and follow-up skills. u2022 Ability to research, obtain, coordinate, and integrate feedback and directions from diverse operational groups. u2022 Experience working with clinical program leadership for action plan and organizational determinations. u2022 Excellent verbal and written communication skills. u2022 Microsoft Office suite/applicable software program(s) proficiency. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $97,299 - $227,679 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Created: 2025-11-01