Manager, Clinical Quality Interventions - RN Required (Remote)

Lensa; Mesa (AZ); Remote; USD 77,000 - 156,000; Full time

Job summary

A leading healthcare company is seeking a Manager for Clinical Quality Interventions. This remote role requires an RN license and involves overseeing quality improvement initiatives, coordinating resources, and collaborating with analytics teams. The ideal candidate will have significant experience in managed healthcare and a strong background in quality improvement.

Benefits

Competitive benefits

Qualifications

• 5+ years in managed healthcare, including 2 years in health plan quality improvement.
• 2+ years' management experience leading healthcare quality teams.

Responsibilities

• Plans and implements quality interventions aligned with state and federal rules.
• Leads operations and implementation of Molina Plan quality interventions.
• Communicates with Molina Senior Leadership on deliverables and issues.

Skills

Quality Improvement

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)

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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, and monitoring for key performance activities, 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 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 through 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 teams is essential for evaluating 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 practices.
• Develops targeted interventions for performance improvement, including outreach to members and providers.
• Leads operations and implementation of Molina Plan quality interventions using established roadmaps, timelines, and KPIs.
• Collaborates with analytics and strategic teams to review and evaluate interventions.
• Communicates with Molina Senior Leadership on deliverables, timelines, barriers, and issues requiring immediate attention.
• Presents summaries and action steps regarding intervention strategies at various meetings.
• Leads and influences cross-functional teams overseeing quality interventions.
• Possesses strong knowledge of quality improvement to drive effective change.
• Serves as a key lead for qualitative analysis, reporting, and development of program materials.
• Supports ongoing management and integrity of programs and outreach initiatives.
• Facilitates strategic relationships with healthcare providers to support quality 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 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 skills.
• Experience developing performance measures supporting business objectives.

Preferred License/Certification

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

Interested employees should apply through the intranet. Molina Healthcare offers competitive benefits. Equal Opportunity Employer. Pay Range: $77,969 - $155,508 annually.