Manager, Health Plan Quality Interventions (Remote)

Lensa; Columbus (OH); Remote; USD 77,000 - 156,000; Full time

Job summary

A leading health plan organization is seeking a Manager for Quality Interventions, responsible for driving quality improvement initiatives and compliance. The role requires a Bachelor’s degree, significant healthcare experience, and skills in project management and data analysis. Join a team focused on enhancing healthcare quality through strategic interventions and stakeholder collaboration.

Qualifications

• 5+ years in managed healthcare, 2 years in health plan quality improvement.
• Operational knowledge of Excel and Visio.
• Preferred certification: Certified Professional in Health Quality (CPHQ).

Responsibilities

• Developing, implementing, and monitoring quality improvement strategies.
• Managing cross-functional teams to drive quality interventions.
• Communicating with leadership on key deliverables and intervention strategies.

Skills

Quality Improvement

Data Analysis

Project Management

Communication

Education

Bachelor's Degree

Master's Degree in Public Health or Healthcare

Tools

Excel

Visio

Job description

Manager, Health Plan Quality Interventions (Remote)

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Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Molina Healthcare.

Job Description

Job Summary

Molina's Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; 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 works to coordinate resources and training within the health plan and identify barriers to established goals and timelines. Key activities include implementing, monitoring, and analyzing the effectiveness of a comprehensive intervention strategy; and facilitating stakeholder input and strategic direction from the interventions Joint Operations Committee that includes leadership from multi-functional areas. The Manager serves as the primary contact for health plan interventions and leads the interventions Joint Operations Committee representing the Molina Plan Senior Leadership Team. In all activities, the Manager works with the national and regional collaborative analytics and strategic team to present and evaluate intervention strategies.

• Plans and/or implements Quality interventions that meet state and federal intervention rules and are aligned with effective practices as identified in the healthcare quality improvement literature and within Molina plans.
• Develops and implements targeted interventions related to performance improvement, including member and provider outreach to improve care and service.
• Serves as operations and implementation lead for Molina Plan quality improvement interventions using a defined roadmap, timeline, and key performance indicators.
• Collaborates with the national intervention collaborative analytics and strategic teams to deliver proposed interventions for review and evaluation.
• Communicates with the Molina Plan Senior Leadership Team, including the Plan President, Chief Medical Officer, national intervention collaborative analytics and strategic teams about key deliverables, timelines, barriers, and escalated issues that need immediate attention.
• Presents concise summaries, key takeaways, and action steps about Molina plan intervention strategy to national, regional and plan meetings.
• Demonstrates ability to lead and influence cross-functional teams that oversee implementation of quality interventions.
• Possesses a strong knowledge in quality to implement effective interventions that drive change.
• Functions as key lead for interventions including qualitative analysis, reporting and development of program materials, templates, or policies.
• Provides on-going support to manage and maintain the integrity of established programs/processes and member/provider outreach initiatives.
• Supports provision of high-quality clinical care and services by facilitating/building strategic relationships with health care providers.
  
  

Job Qualifications

Required Education

Bachelor's Degree or equivalent work experience.

Required Experience

• 5+ years' experience in managed healthcare, including at least 2 years in health plan quality improvement or equivalent/related experience.
• Operational knowledge and experience with Excel and Visio (flow chart equivalent).
  
  

Preferred Education

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

Preferred Experience

• 3+ years' experience with member/ provider (HEDIS) outreach and/or quality intervention or improvement studies (development, implementation, evaluation).
• Supervisory experience.
• Project management and team building experience.
• Experience developing performance measures that support business objectives.
• Preferred License, Certification, Association
• Certified Professional in Health Quality (CPHQ)
• Active Nursing License (RN may be required for specific roles)
• Certified HEDIS Compliance Auditor (CHCA)
  
  

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

#PJQA

Pay Range: $77,969 - $155,508 / ANNUAL

• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
  
  

If you have questions about this posting, please contact [e-mail]

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Management and Manufacturing

• Industries

  IT Services and IT Consulting

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