Analyst, Quality Interventions/QI Compliance (Remote in CA)

Lensa; California; Remote; USD 68,000 - 112,000; Full time

Job summary

A leading healthcare provider is seeking a Quality Improvement Analyst to enhance service quality for members. The role involves analyzing data, preparing reports, and ensuring compliance with regulatory standards. Candidates should have a background in healthcare quality improvement and strong analytical skills.

Benefits

Competitive Benefits

Qualifications

• Minimum of 3 years in healthcare, with 1 year in health plan quality improvement.
• Experience in Medicare and Medicaid preferred.

Responsibilities

• Collaborating to analyze quality improvement studies.
• Preparing reports and conducting analyses for performance improvements.
• Participating in NCQA accreditation and regulatory audits.

Skills

Business Writing

Data Analysis

Quality Improvement

Education

Bachelor's Degree

Master's Degree

Tools

Excel

Visio

Job description

Job Description

Lensa is the leading career site for job seekers at every stage of their career. Our client, Molina Healthcare, is seeking professionals. Apply via Lensa today!

Job Summary

Molina's Quality Improvement function oversees, plans, and implements healthcare quality improvement initiatives and education programs. It ensures maintenance of programs for members according to prescribed quality standards, conducts data collection, reporting, and monitoring for key performance activities, and manages NCQA accreditation surveys and federal/state QI compliance activities.

Knowledge/Skills/Abilities

The Analyst, Quality Improvement (QI) Interventions/Compliance, contributes to Clinical Quality Interventions and Quality Improvement Compliance. Responsibilities include:

• Collaborating with Quality Improvement staff to analyze and report on quality improvement studies and initiatives to enhance healthcare service quality for Molina members.
• Evaluating quality improvement data collection, evaluation, and dissemination for compliance with regulatory and accreditation standards.
• Preparing and presenting reports and analyses using various data sources to evaluate performance improvements.
• Producing graphical reports on QI project results, ensuring timely delivery to meet business and regulatory requirements.
• Conducting qualitative and quantitative analyses to identify urgent concerns and develop improvement plans.
• Participating in NCQA accreditation and regulatory audits, including report preparation and policy updates.
• Other activities may include analyzing quality of care issues, credentialing files, and quality metrics such as HEDIS and STARS.

Job Qualifications

Required Education

Bachelor's Degree or equivalent experience.

Required Experience

• Minimum of 3 years in healthcare, with 1 year in health plan quality improvement or managed care.
• Strong business writing skills.
• Operational knowledge of Excel and Visio.

Preferred Education

Master's Degree or higher in a clinical field, Public Health, or Healthcare.

Preferred Experience

• Experience in Medicare and Medicaid (1 year).
• HEDIS reporting or collection experience.
• Experience with performance measures supporting business objectives.

Preferred Licenses/Certifications

• Certified Professional in Health Quality (CPHQ).
• Nursing License (RN preferred for some roles).
• Certified HEDIS Compliance Auditor (CHCA).

Current Molina employees interested in this position should apply through the intranet. Molina Healthcare offers competitive benefits and is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $68,640 - $111,967 annually. Actual compensation varies based on location, experience, education, and skills.