Manager, Clinical Quality Interventions - RN Required (Remote)

Lensa; West Valley City (UT); Remote; USD 77,000 - 156,000; Full time

Job summary

A leading company in healthcare is seeking a Manager for Clinical Quality Interventions. This remote role requires an active RN license and involves developing and implementing quality improvement initiatives. The ideal candidate will have significant experience in managed healthcare and strong leadership skills. Join a team dedicated to enhancing healthcare quality and compliance.

Qualifications

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

Responsibilities

• Develops and implements quality improvement interventions.
• Coordinates resources and training within the health plan.
• Communicates with senior leadership about key deliverables.

Skills

Leadership

Quality Improvement

Communication

Education

Master’s Degree

Active RN License

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 for 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 strategic activities involving stakeholders and leadership. The role involves serving as the primary contact for interventions, leading the interventions Joint Operations Committee, and working with analytics teams to evaluate strategies.

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

• 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 of quality initiatives with clear roadmaps 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 to various meetings.
• Leads and influences cross-functional teams for quality interventions.
• Has strong knowledge of quality to implement effective change strategies.
• Functions as the key lead for qualitative analysis, reporting, and program development.
• Supports ongoing management of programs and outreach initiatives.
• Builds strategic relationships with healthcare providers to support quality care.

Job Qualifications

Required Education: Active, unrestricted RN License.

Required Experience: 5+ years in managed healthcare, including 2+ years in health plan quality improvement or related fields; 2+ years in management; operational knowledge of Excel and Visio.

Preferred Education: Master’s Degree or higher in a clinical or healthcare field.

Preferred Experience: 3+ years in member/provider outreach, quality intervention, or improvement studies; supervisory experience; project management; developing performance measures.

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, varies by location and experience.

Additional Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Healthcare Provider