Health Plan Member & Community Interventions Specialist

Molina Healthcare; San Antonio (TX); On-site; USD 50,000 - 97,000; Full time

Benefits offered by this job

Competitive benefits package

Job summary

Molina Healthcare in Texas seeks a Quality Intervention Specialist to support clinical quality member interventions across Medicare, Marketplace, and Medicaid. You will develop and implement data-informed programs aligned with NCQA regulations and internal standards.

Responsibilities include monitoring intervention activity, writing reports, and collaborating with community-based organizations to improve care. Travel up to 20% may be required; CP HQ/CHCA preferred for growth; RN license optional.

Qualifications

• 2+ years of health care experience with 1+ year in health plan quality interventions.
• Strong business writing, data analysis, and NCQA knowledge.
• Ability to work independently in a fast-paced environment and communicate effectively.

Responsibilities

• Implements evidence-based member/intervention strategies and reports outcomes.
• Monitors timely completion of activities and presents results to management.
• Writes reports interpreting regulatory specifications and program results.
• Creates documentation to maintain program milestones and deliverables.
• Participates in quality improvement activities and cross-department collaboration.
• Builds relationships with community-based organizations to support care.
• Evaluates projects to identify opportunities for improvement.
• Identifies process gaps and communicates remediation to leadership.
• Travel 0-20% or multi-day trips may be required.

Skills

Health care experience

Quality interventions

Data analysis

Business writing

Communication skills

MS Office proficiency

Education

CPHQ (preferred)

CHCA (preferred)

RN license (optional)

Tools

MS Office

Job description

Molina Healthcare in Texas seeks a Quality Intervention Specialist to support clinical quality member interventions across Medicare, Marketplace, and Medicaid. You will develop and implement data-informed programs aligned with NCQA regulations and internal standards.

Responsibilities include monitoring intervention activity, writing reports, and collaborating with community-based organizations to improve care. Travel up to 20% may be required; CP HQ/CHCA preferred for growth; RN license optional.