Manager, Health Plan Quality Interventions - RN Required (Remote)

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

Job summary

A leading healthcare organization seeks a Manager for Health Plan Quality Interventions, requiring an active RN license and substantial experience in healthcare management. The role involves developing, implementing, and monitoring quality improvement strategies, overseeing performance metrics and stakeholder collaboration in a remote setting.

Benefits

Competitive benefits

Qualifications

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

Responsibilities

• Develops and monitors quality improvement interventions.
• Coordinates resources and implements strategies.
• Leads cross-functional teams for quality initiatives.

Skills

Quality Improvement

Data Analysis

Stakeholder Engagement

Education

Active, unrestricted RN License

Master's Degree or higher in a clinical or healthcare field

Tools

Excel

Visio

Job description

Manager, Health Plan Quality Interventions - RN Required (Remote)

Be among the first 25 applicants. Get AI-powered advice on this job and more exclusive features.

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; maintains programs for members according to quality standards; conducts data collection, reporting, and monitoring for key performance activities; and manages NCQA accreditation surveys and QI compliance activities.

Knowledge/Skills/Abilities

The Manager, Health Plan Quality Interventions develops, implements, and monitors quality improvement interventions. Responsibilities include coordinating resources, identifying barriers, implementing and analyzing interventions, and facilitating stakeholder input through the Interventions Joint Operations Committee, which includes leadership from various departments. The Manager acts as the primary contact for interventions and leads the committee, collaborating with analytics and strategic teams to evaluate strategies.

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

• Plans and implements quality interventions aligned with state and federal rules and best practices.
• Develops targeted interventions for performance improvement and outreach.
• Leads operations for quality interventions using defined roadmaps, timelines, and KPIs.
• Collaborates with analytics teams to review intervention proposals.
• Communicates with senior leadership regarding key deliverables and issues.
• Prepares summaries and action steps for meetings.
• Leads cross-functional teams to implement quality interventions.
• Has strong knowledge of quality improvement to drive change.
• Leads qualitative analysis, reporting, and program development.
• Supports program integrity and member/provider outreach initiatives.
• Builds strategic relationships to support clinical care quality.

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 in healthcare 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 and quality studies.
• Supervisory and project management experience.
• Experience developing performance measures.

Preferred Certifications

• CPHQ
• CHCA

Interested employees should apply through the intranet. Molina offers competitive benefits. Equal Opportunity Employer. Pay Range: $77,969 - $155,508 annually.

Additional Details

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