Manager, Clinical Quality Interventions - RN Required (Remote)

Lensa; Caldwell (ID); Remote; USD 77,000 - 156,000; Full time

Job summary

A leading healthcare organization is seeking a Manager for Clinical Quality Interventions. This role involves overseeing quality improvement initiatives and collaborating with various teams to enhance healthcare standards. Candidates must hold an active RN license and have extensive experience in managed healthcare and quality improvement.

Qualifications

• 5+ years in managed healthcare, including 2+ years in health plan quality improvement.
• 2+ years' management experience leading healthcare quality teams.
• Experience with member/provider outreach and quality intervention studies.

Responsibilities

• Develops and implements quality improvement interventions.
• Coordinates resources and identifies barriers.
• Leads cross-functional teams for implementation of quality interventions.

Skills

Quality Improvement

Data Analysis

Collaboration

Leadership

Education

Active, unrestricted RN License

Master's Degree or higher in a clinical field

Tools

Excel

Visio

Job description

Manager, Clinical Quality Interventions - RN Required (Remote)

3 days ago Be among the first 25 applicants

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 Description

Job Summary

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

Knowledge/Skills/Abilities

The Manager, Health Plan Quality Interventions is responsible for developing, implementing, and monitoring quality improvement interventions. The role involves coordinating resources, identifying barriers, implementing and analyzing interventions, and facilitating stakeholder input from the interventions Joint Operations Committee, which includes leadership from various areas. The Manager acts as the primary contact for health plan interventions and leads the interventions Joint Operations Committee, representing Molina Plan Senior Leadership. Collaboration with national and regional analytics and strategic teams is essential for evaluating intervention strategies.

Note: Only individuals with an RN license are being considered at this time.

• Plans and implements quality interventions aligned with state and federal rules and best practices.
• Develops targeted interventions for performance improvement, including member and provider outreach.
• Leads operations and implementation for Molina Plan quality initiatives using defined roadmaps, timelines, and KPIs.
• Collaborates with analytics and strategic teams on intervention proposals.
• Communicates with Molina Senior Leadership on key deliverables, barriers, and issues.
• Presents summaries and action steps in meetings.
• Leads and influences cross-functional teams for implementation of quality interventions.
• Has strong knowledge in quality to drive effective change.
• Leads qualitative analysis, reporting, and development of program materials.
• Supports ongoing management of programs and outreach initiatives.
• Facilitates strategic relationships with healthcare providers to support high-quality care.

Job Qualifications

Required Education

Active, unrestricted RN License.

Required Experience

5+ years in managed healthcare, including 2+ years in health plan quality improvement or related roles; 2+ years' management experience leading healthcare quality teams; operational knowledge of Excel and Visio.

Preferred Education

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

Preferred Experience

• 3+ years' experience with member/provider outreach and quality intervention studies.
• Supervisory experience.
• Project management and team building experience.
• Experience developing performance measures supporting business objectives.

Preferred License/Certification

• Certified Professional in Health Quality (CPHQ)
• Certified HEDIS Compliance Auditor (CHCA)

To apply, current Molina employees should use the intranet job listing. Molina offers competitive benefits. Equal Opportunity Employer. Pay Range: $77,969 - $155,508 annually. Actual compensation varies based on location, experience, education, and skills.

Additional Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Health Care Provider

Referrals increase your chances of interviewing at Lensa by 2x. Get notified about new Clinical Manager jobs in Caldwell, ID.