Manager, Clinical Quality Interventions - RN Required (Remote)

Lensa; Covington (KY); Remote; USD 70,000 - 110,000; Full time

Job summary

An established industry player is seeking a Manager of Clinical Quality Interventions to lead quality improvement initiatives in a remote setting. This pivotal role involves developing strategies to enhance healthcare quality, ensuring compliance with standards, and collaborating with cross-functional teams. With a focus on member and provider outreach, the ideal candidate will leverage their extensive experience in managed healthcare to drive impactful changes. If you are passionate about improving healthcare quality and have a strong leadership background, this opportunity is perfect for you.

Qualifications

• 5+ years of experience in managed healthcare with a focus on quality improvement.
• Management experience leading healthcare quality teams.

Responsibilities

• Plan and implement quality interventions aligned with healthcare standards.
• Lead operations for quality improvement initiatives, monitoring progress.

Skills

Managed Healthcare Experience

Quality Improvement Strategies

Leadership Skills

Excel

Visio

Education

Active RN License

Master's Degree in Clinical or Healthcare Field

Tools

Excel

Visio

Job description

Manager, Clinical Quality Interventions - RN Required (Remote)

This position is for a Manager of Clinical Quality Interventions at Molina Healthcare. The role involves developing, implementing, and monitoring healthcare quality improvement initiatives, ensuring compliance with standards, and leading intervention strategies.

Key Responsibilities:

• Plan and implement quality interventions aligned with healthcare standards.
• Develop targeted performance improvement strategies involving member and provider outreach.
• Lead operations for quality improvement initiatives, monitoring progress with KPIs.
• Collaborate with analytics and strategic teams to evaluate interventions.
• Communicate with senior leadership regarding project status, barriers, and escalations.
• Present summaries and strategic insights at meetings.
• Lead cross-functional teams to ensure effective intervention implementation.
• Provide ongoing support to maintain program integrity and build strategic relationships with healthcare providers.

Minimum Qualifications:

• Active, unrestricted RN license.
• At least 5 years of experience in managed healthcare, with 2+ years in health plan quality improvement or related fields.
• Management experience leading healthcare quality teams.
• Operational knowledge of Excel and Visio.

Preferred Qualifications:

• Master's degree in a clinical or healthcare field.
• 3+ years experience with member/provider outreach and quality studies.
• Supervisory and project management experience.
• Certifications such as CPHQ or CHCA are a plus.