Manager, Clinical Quality Interventions - RN Required (Remote)

Lensa; Dallas (TX); 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 RN license and involves overseeing quality improvement initiatives, collaborating with teams, and leading interventions. Ideal candidates have extensive experience in managed healthcare and quality improvement.

Benefits

Competitive benefits

Qualifications

• 5+ years in managed healthcare, including 2 years in quality improvement.
• 2+ years' management experience leading a healthcare quality team.

Responsibilities

• Plans and implements quality interventions aligned with regulations.
• Communicates with leadership about key deliverables and barriers.
• Leads cross-functional teams implementing quality interventions.

Skills

Quality Improvement

Leadership

Communication

Data Analysis

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)

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; ensures maintenance of programs for members in accordance with prescribed quality standards; conducts data collection, reporting, and monitoring for key performance measurement activities; and provides direction and implementation of 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 Manager works to coordinate resources and training within the health plan, identify barriers to goals and timelines, and lead the interventions Joint Operations Committee that includes leadership from multi-functional areas. The Manager serves as the primary contact for health plan interventions and leads the interventions Joint Operations Committee representing Molina Plan Senior Leadership. The Manager collaborates with national and regional analytics and strategic teams to present and evaluate 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 effective healthcare quality improvement practices.
• Develops targeted interventions for performance improvement, including member and provider outreach.
• Leads operations and implementation for Molina Plan quality improvement initiatives, using defined roadmaps, timelines, and KPIs.
• Collaborates with analytics and strategic teams to review and evaluate interventions.
• Communicates with Molina Plan Senior Leadership about key deliverables, barriers, and issues.
• Presents summaries and action steps regarding intervention strategies to various meetings.
• Leads and influences cross-functional teams implementing quality interventions.
• Possesses strong knowledge of quality to implement effective change initiatives.
• Leads qualitative analysis, reporting, and development of program materials or policies.
• Supports ongoing management and integrity of established programs and outreach initiatives.
• Facilitates strategic relationships with healthcare providers to support high-quality clinical care.

Job Qualifications

Required Education

Active, unrestricted RN License.

Required Experience

5+ years in managed healthcare, including at least 2 years in health plan quality improvement or related experience; 2+ years' management experience leading a healthcare quality team; 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 or improvement studies.
• Supervisory experience.
• Project management and team building experience.
• Experience developing performance measures supporting business objectives.

Preferred License, Certification, and Associations

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

To apply, current Molina employees should do so via the intranet. Molina offers competitive benefits. Equal Opportunity Employer. Pay Range: $77,969 - $155,508 annually.