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

Lensa; Nampa (ID); Remote; USD 77,000 - 156,000; Full time

Job summary

A leading healthcare organization is seeking a Manager for Health Plan Quality Interventions, requiring an active RN license and extensive experience in quality improvement. The role involves developing and monitoring quality initiatives, collaborating with teams, and leading operations to ensure compliance with healthcare standards.

Qualifications

• 5+ years in managed healthcare with 2+ years in health plan quality improvement.
• Experience leading healthcare quality teams and developing performance measures.
• Strong operational knowledge and project management skills.

Responsibilities

• Develops and implements quality improvement interventions.
• Coordinates resources and facilitates stakeholder input.
• Leads cross-functional teams overseeing intervention implementation.

Skills

Quality Improvement

Data Analysis

Stakeholder Engagement

Education

Active, unrestricted RN License

Master's Degree or higher in a clinical field

Tools

Excel

Visio

Job description

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

Be among the first 25 applicants. 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 according to prescribed 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, is responsible for developing, implementing, and monitoring quality improvement interventions. The role involves coordinating resources, training, identifying barriers, implementing and analyzing intervention strategies, and facilitating stakeholder input through the interventions Joint Operations Committee, which includes leadership from various departments. The Manager is the primary contact for health plan interventions and leads the committee, representing Molina Plan Senior Leadership. Collaboration with analytics and strategic teams is essential for evaluating intervention strategies.

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

• Plans and implements quality interventions aligned with state and federal regulations and best practices.
• Develops targeted interventions for performance improvement, including member and provider outreach.
• Leads operations and implementation for Molina Plan quality interventions, following a defined roadmap and KPIs.
• Collaborates with analytics and strategic teams to review and evaluate interventions.
• Communicates with Molina Senior Leadership about deliverables, timelines, barriers, and issues.
• Presents summaries and action plans in meetings at various levels.
• Leads and influences cross-functional teams overseeing intervention implementation.
• Utilizes strong quality knowledge to implement effective change strategies.
• Leads qualitative analysis, reporting, and development of program materials.
• Supports the integrity of established 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 at least 2 years in health plan quality improvement; 2+ years' management experience leading healthcare quality teams; operational knowledge of Excel and Visio.

Preferred Education

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

Preferred Experience

• 3+ years' experience with member/provider outreach and quality intervention studies.
• Supervisory experience.
• Project management and team building experience.
• Experience developing performance measures supporting business objectives.

Preferred License/Certification

• CPHQ
• CHCA

Current Molina employees interested in this position should apply through the intranet. Molina Healthcare offers competitive benefits. We are an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $77,969 - $155,508/year. Actual compensation may vary based on location, experience, education, and skills.

Additional Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Management
• Industries: IT Services and Consulting

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