Manager, Clinical Quality Interventions - RN Required (Remote)

Lensa; Miami (FL); Remote; USD 80,000 - 100,000; 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, coordinating resources, and leading cross-functional teams to enhance healthcare quality standards.

Benefits

Competitive benefits

Qualifications

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

Responsibilities

• Plans and implements quality interventions aligned with state and federal rules.
• Leads operations for Molina Plan quality interventions.
• Builds strategic relationships with healthcare providers.

Skills

Leadership

Project Management

Team Building

Communication

Education

Master's Degree or higher in a clinical field

Active, unrestricted RN License

Tools

Excel

Visio

Job description

Manager, Clinical Quality Interventions - RN Required (Remote)

This job description is well-structured and provides comprehensive information about the role, responsibilities, qualifications, and company details. However, it contains some redundancies and irrelevant content, such as multiple job listings and promotional statements that do not pertain directly to the specific role. To improve clarity and focus, I will remove the repetitive headers, unrelated job listings, and promotional content, and ensure the formatting is clean and consistent.

Below is the refined version:

Manager, Clinical Quality Interventions - RN Required (Remote)

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 develops, implements, and monitors the success of quality improvement interventions. This role involves coordinating resources and training, identifying barriers, implementing and analyzing intervention strategies, and facilitating stakeholder input through the interventions Joint Operations Committee. The Manager is the primary contact for health plan interventions, leading the committee and working with analytics and strategic teams to evaluate strategies. All activities require an RN license.

• Plans and implements quality interventions aligned with state and federal rules and best practices.
• Develops targeted interventions for performance improvement, including outreach to members and providers.
• Leads operations and implementation for Molina Plan quality interventions, using defined roadmaps, timelines, and KPIs.
• Collaborates with analytics and strategic teams to review and evaluate interventions.
• Communicates with senior leadership regarding deliverables, timelines, barriers, and issues.
• Presents summaries and action steps in meetings.
• Leads and influences cross-functional teams overseeing quality interventions.
• Implements effective quality strategies that drive change.
• Develops program materials, templates, and policies related to interventions.
• Supports ongoing management of programs and outreach initiatives.
• Builds strategic relationships with healthcare providers to ensure high-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; 2+ years in healthcare management; 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.
• Certifications such as CPHQ or CHCA are a plus.

Interested candidates should apply through the appropriate channels. Molina Healthcare offers competitive benefits and is an Equal Opportunity Employer.