Manager, Clinical Quality Interventions - RN Required (Remote)

Lensa; Salt Lake City (UT); 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, managing accreditation surveys, and collaborating with various teams to enhance healthcare quality.

Benefits

Competitive benefits

Qualifications

• 5+ years in managed healthcare, with at least 2 years in health plan quality improvement.
• 2+ years' management experience leading a healthcare quality team.

Responsibilities

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

Skills

Leadership

Quality Improvement

Communication

Education

Master's Degree or higher in a clinical, public health, or healthcare field

Active, unrestricted RN License

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. It ensures maintenance of programs for members in accordance with quality standards, conducts data collection, reporting, and monitoring for key performance activities, and manages NCQA accreditation surveys and QI compliance activities.

Knowledge/Skills/Abilities

The Manager, Health Plan Quality Interventions develops, implements, and monitors quality improvement interventions. Responsibilities include coordinating resources, identifying barriers, implementing and analyzing intervention strategies, and facilitating stakeholder input through the interventions Joint Operations Committee. The Manager acts as the primary contact for interventions and leads the committee, working with analytics and strategic teams to evaluate strategies.

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

• Plans and implements quality interventions aligned with state and federal rules and healthcare literature.
• Develops targeted interventions for performance improvement and outreach.
• Leads operations and implementation for Molina Plan quality initiatives with defined roadmaps and KPIs.
• Collaborates with analytics and strategic teams to review interventions.
• Communicates with Molina Senior Leadership on deliverables, barriers, and issues.
• Presents summaries and action plans at meetings.
• Leads and influences cross-functional teams to implement quality interventions.
• Has strong knowledge of quality practices to drive change.
• Leads qualitative analysis, reporting, and program development.
• Supports ongoing program integrity and outreach initiatives.
• Builds strategic relationships with healthcare providers to support clinical care quality.

Job Qualifications

Required Education

Active, unrestricted RN License.

Required Experience

5+ years in managed healthcare, with at least 2 years in health plan quality improvement. 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, public health, or healthcare field.

Preferred Experience

• 3+ years' experience with member/provider outreach and quality improvement studies.
• Supervisory experience.
• Project management and team building skills.
• Experience developing performance measures supporting business objectives.

Preferred Certifications

• CPHQ
• CHCA

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