Manager, Clinical Quality Interventions - RN Required (Remote)

Lensa; Sterling Heights (MI); Remote; USD 77,000 - 156,000; Full time

Job summary

A leading healthcare organization is seeking a Manager for Clinical Quality Interventions to oversee quality improvement initiatives. This remote position requires an active RN license and extensive experience in managed healthcare. The successful candidate will lead quality interventions, collaborate with analytics teams, and communicate with senior leadership to ensure compliance and performance improvement.

Benefits

Competitive benefits

Qualifications

• 5+ years in managed healthcare, including 2+ years in health plan quality improvement.
• 2+ years' management experience leading a healthcare quality team.
• Operational knowledge of Excel and Visio.

Responsibilities

• Develops, implements, and monitors quality improvement interventions.
• Coordinates resources and training within the health plan.
• Leads operations and implementation of quality interventions.

Skills

Quality improvement strategies

Data collection

Leadership

Communication

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)

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 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 coordinates resources and training within the health plan, identifies barriers to goals and timelines, and leads the interventions Joint Operations Committee, including senior leadership. The role involves working with analytics teams to evaluate intervention strategies.

Only individuals with an RN license are 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 member and provider outreach.
• Leads operations and implementation of 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 about key deliverables, barriers, and issues.
• Presents summaries and action steps in meetings.
• Leads and influences cross-functional teams overseeing quality interventions.
• Possesses strong knowledge in quality improvement strategies.
• Serves as the key lead for qualitative analysis, reporting, and program development.
• Supports ongoing management of established programs and outreach initiatives.
• Builds 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 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 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: CPHQ, CHCA.

Interested employees should apply through the intranet. Molina offers competitive benefits. EOE. Pay range: $77,969 - $155,508 annually.