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Manager, Health Plan Quality Interventions - RN Required (Remote)
Lensa
City of Albany (NY)
Remote
USD 77,000 - 156,000
Full time
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Job summary
A leading healthcare organization is seeking a Manager for Health Plan Quality Interventions, responsible for enhancing quality improvement initiatives. The ideal candidate will possess an active RN license and over five years of relevant healthcare experience, focusing on implementing effective strategies that meet state and federal rules. The role includes leading teams, facilitating stakeholder input, and driving quality outcomes through collaborative analytics.
Benefits
Qualifications
- 5+ years' experience in managed healthcare, including 2+ years in health plan quality improvement.
- Operational experience with Excel and Visio.
- Supervisory and project management experience preferred.
Responsibilities
- Develop and implement quality improvement interventions.
- Coordinate resources and training within the health plan.
- Lead the quality interventions Joint Operations Committee.
Skills
Education
Tools
Job description
Molina Healthcare
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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.
Only individuals with an RN license are being considered at this time.
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
Active, unrestricted RN License.
Required Experience
5+ years' experience in managed healthcare, including at least 2 years in health plan quality improvement or equivalent/related experience.
2+ years' management experience leading a healthcare quality team.
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)
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.
Pay Range: $77,969 - $155,508 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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Manager, Health Plan Quality Interventions - RN Required (Remote)
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...
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