Manager, Health Plan Quality Interventions (Remote)

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

Job summary

A leading healthcare provider is seeking a Manager for Health Plan Quality Interventions to oversee health care quality improvement initiatives. This remote role involves implementing strategies, collaborating with multi-functional teams, and ensuring compliance with performance standards. Candidates should possess a strong background in managed healthcare with significant experience in quality improvement.

Qualifications

• 5+ years' experience in managed healthcare, including 2 years in health plan quality improvement.
• Operational knowledge of quality improvement within healthcare settings.

Responsibilities

• Develops and implements quality improvement interventions.
• Coordinates resources and training to meet health plan goals.

Skills

Analytical skills

Leadership

Communication

Education

Bachelor's Degree or equivalent work experience

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

Tools

Excel

Visio

Job description

Manager, Health Plan Quality Interventions (Remote)

Manager, Health Plan Quality Interventions (Remote)

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

  Internet Publishing

Referrals increase your chances of interviewing at Lensa by 2x

Get notified about new Plan Manager jobs in United States.

Health Plan Operations Manager - Remote ($150K)

United States $130,000.00-$140,000.00 2 weeks ago

Senior Client Success Manager, Health Plans

United States $114,330.00-$163,504.00 1 week ago

Pension Plan Paying Agent Operations Manager Sr

Senior Business Development Manager - AWG

Iowa, United States $120,827.00-$217,399.00 1 day ago

United States $114,330.00-$163,504.00 14 hours ago

Business Applications Consultant - Deltek Replicon

United States $91,800.00-$120,000.00 2 days ago

United States $130,000.00-$140,000.00 12 hours ago

Business Development Manager - Central Florida

United States $75,189.00-$124,062.00 4 days ago

Chicago, IL $90,000.00-$115,000.00 2 days ago

United States $105,900.00-$169,100.00 2 weeks ago

Strategic Accounts Manager (Health Plans)

Denver, CO $115,000.00-$130,000.00 4 weeks ago

Strategic Accounts Manager (Health Plans)

Portland, OR $115,000.00-$130,000.00 4 weeks ago

Compliance Manager - Health Plan/CMS (Remote)

Sr. Principal - SAP Record to Report - Business Consulting

United States $157,500.00-$192,500.00 1 week ago

United States $120,000.00-$135,000.00 2 weeks ago

United States $225,000.00-$285,000.00 4 days ago

Strategic Accounts Manager (Health Plans)

Seattle, WA $115,000.00-$130,000.00 4 weeks ago

Strategic Accounts Manager (Health Plans)

Phoenix, AZ $115,000.00-$130,000.00 4 weeks ago

Strategic Accounts Manager (Health Plans)

Los Angeles, CA $115,000.00-$130,000.00 4 weeks ago

Sr. Marketing Manager, Demand Generation

United States $95,000.00-$125,000.00 4 days ago

United States $130,000.00-$160,000.00 3 weeks ago

Strategic Accounts Manager (Health Plans)

Sacramento, CA $115,000.00-$130,000.00 4 weeks ago

We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI.