Manager, Clinical Quality Interventions - RN Required (Remote)

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

Job summary

A leading healthcare organization is seeking a Manager for Clinical Quality Interventions, requiring an active RN license and extensive experience in managed healthcare. The role involves developing quality improvement strategies, leading initiatives, and collaborating with various teams to enhance healthcare quality standards. Candidates should have a strong background in healthcare management, with a focus on quality improvement and data analysis.

Benefits

Competitive benefits

Equal Opportunity Employer

Qualifications

• 5+ years in managed healthcare, with 2+ years in health plan quality improvement.
• 2+ years' management experience leading a healthcare quality team.
• Experience with member/provider outreach and quality intervention studies.

Responsibilities

• Develops and implements quality improvement interventions.
• Coordinates resources and identifies barriers for quality initiatives.
• Communicates with senior leadership about deliverables and timelines.

Skills

Leadership

Quality Improvement

Data Analysis

Collaboration

Education

Active, unrestricted RN License

Master's Degree or higher in a clinical field, Public Health, or Healthcare

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 in accordance with quality standards, conducts data collection, reporting, monitoring, and provides direction for NCQA accreditation surveys and 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, identifying barriers, implementing and analyzing interventions, and facilitating stakeholder input. 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 analytics and strategic teams is essential.

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

• Plans and implements quality interventions aligned with state and federal regulations and effective healthcare practices.
• Develops targeted interventions for performance improvement, including member and provider outreach.
• Leads operations and implementation for Molina Plan quality initiatives with defined roadmaps and KPIs.
• Collaborates with analytics and strategic teams to review and evaluate interventions.
• Communicates with senior leadership about deliverables, timelines, barriers, and issues.
• Presents summaries and action steps in meetings.
• Leads and influences cross-functional teams for quality interventions.
• Implements effective interventions based on quality knowledge.
• Develops program materials, templates, and policies.
• Supports ongoing management of programs and outreach initiatives.
• Facilitates strategic relationships with healthcare providers to support clinical care and services.

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 or related areas. 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 studies.
• Supervisory experience.
• Project management and team building experience.
• Experience developing performance measures supporting business objectives.

Preferred License/Certifications

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

To apply, current Molina employees should use the intranet job listing. Molina Healthcare offers competitive benefits. We are an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $77,969 - $155,508 annually. Actual compensation varies based on location, experience, education, and skills.