Manager, Clinical Quality Interventions - RN Required (Remote)

Lensa; United States; Remote; USD 77,000 - 156,000; Full time

Job summary

A leading company in healthcare is seeking a Manager for Clinical Quality Interventions. This role involves overseeing quality improvement initiatives, collaborating with analytics teams, and ensuring compliance with healthcare standards. Candidates must possess an active RN license and have significant experience in managed healthcare and quality improvement.

Benefits

Competitive benefits

Qualifications

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

Responsibilities

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

Skills

Leadership

Analytical Skills

Communication

Quality Improvement

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 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 leads the interventions Joint Operations Committee, representing Molina Plan Senior Leadership. The role involves working with analytics and strategic 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 practices.
• Develops targeted interventions for performance improvement, including outreach to members and providers.
• Leads operations and implementation for quality improvement initiatives using defined roadmaps and KPIs.
• Collaborates with analytics and strategic teams for intervention review.
• Communicates with senior leadership about deliverables, timelines, and issues.
• Presents summaries and action steps in meetings.
• Leads and influences cross-functional teams in implementing quality interventions.
• Implements effective interventions to drive change.
• Develops program materials, reports, and policies.
• Supports program integrity and outreach initiatives.
• Facilitates strategic relationships with healthcare providers.

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; 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 in member/provider outreach and quality studies.
• Supervisory experience.
• Project management and team building.
• Developing performance measures supporting business objectives.

Preferred Certifications

• CPHQ
• CHCA

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