Manager, Clinical Quality Interventions - RN Required (Remote)

Lensa; Columbus (GA); Remote; USD 77,000 - 156,000; Full time

Job summary

A leading healthcare organization is seeking a Manager for Clinical Quality Interventions. This remote role requires an active RN license and focuses on developing and implementing quality improvement initiatives. The successful candidate will lead cross-functional teams, analyze data, and ensure compliance with healthcare standards while driving effective change in quality care delivery.

Qualifications

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

Responsibilities

• Develop and implement quality interventions aligned with regulations.
• Lead operations and implementation of quality interventions.
• Communicate with senior leadership on key deliverables and issues.

Skills

Quality Improvement

Data Analysis

Communication

Project Management

Education

Active, unrestricted RN License

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

Tools

Excel

Visio

Job description

Manager, Clinical Quality Interventions - RN Required (Remote)

1 day ago Be among the first 25 applicants

Get AI-powered advice on this job and more exclusive features.

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 maintenance of programs for members according to prescribed quality standards, conducts data collection, reporting, monitoring for key performance metrics, and manages NCQA accreditation surveys and federal/state QI compliance activities.

Knowledge/Skills/Abilities

The Manager, Health Plan Quality Interventions is responsible for developing, implementing, and monitoring the success of quality improvement interventions. The role involves coordinating resources and training within the health plan, identifying barriers to goals, implementing and analyzing intervention strategies, and facilitating stakeholder input. The Manager leads the interventions Joint Operations Committee, representing Molina Plan Senior Leadership, and collaborates with analytics and strategic teams to evaluate strategies.

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

• Plan and implement quality interventions aligned with state and federal regulations and effective practices.
• Develop targeted interventions to improve performance, including member and provider outreach.
• Lead operations and implementation of quality interventions with defined roadmaps, timelines, and KPIs.
• Collaborate with analytics and strategic teams for intervention review and evaluation.
• Communicate with Molina Senior Leadership on key deliverables, barriers, and issues.
• Present summaries and action steps to various meetings.
• Lead and influence cross-functional teams overseeing intervention implementation.
• Apply strong quality knowledge to drive effective change.
• Lead qualitative analysis, reporting, and development of program materials.
• Support ongoing management of programs and outreach initiatives.
• Facilitate strategic relationships with healthcare providers to ensure high-quality care.

Job Qualifications

Required Education

Active, unrestricted RN License.

Required Experience

At least 5 years in managed healthcare, with 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 in member/provider outreach and quality intervention studies.
• Supervisory experience.
• Project management and team building experience.
• Experience developing performance measures supporting business objectives.

Preferred Certifications

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

Interested Molina employees should apply through the intranet. Molina Healthcare offers competitive benefits. We are an 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: Healthcare Provider
• Industries: IT Services and Consulting