Member Interventions & Quality Improvement Specialist

Molina Healthcare; Iowa; Remote; USD 47,000 - 92,000; Full time

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare is seeking a skilled professional to support clinical quality member intervention activities across Medicare, Marketplace, Medicaid, and other lines of business. You will develop and implement interventions, monitor outcomes, and report results to leadership, ensuring regulatory compliance and continuous improvement.

Role involves building relationships with community organizations and evaluating interventions for effectiveness.

Qualifications

• At least 2 years in health care with 1+ year in health plan quality interventions.
• Solid business writing experience.
• Proficiency in data analysis, manipulation, and interpretation.
• Basic knowledge of HEDIS and NCQA.
• Strong analytical and problem-solving skills.
• Detail-oriented with strong organizational skills.
• Able to adapt to change and work independently in a fast-paced environment.
• Excellent verbal and written communication skills.
• Proficient with Microsoft Office and related software.

Responsibilities

• Implement evidence-based and data-informed member intervention strategies.
• Monitor timely completion of interventions and present results to management.
• Write narrative reports interpreting regulatory specifications and program results.
• Create and manage documentation for program milestones and deliverables.
• Participate in quality improvement activities and cross-department discussions.
• Support quality of care by building relationships with community organizations.
• Evaluate project activities and identify opportunities for improvement.
• Flag process gaps to quality leadership.
• Travel up to 80% locally or state-specific requirements; multi-day trips may occur.

Skills

Business writing

Data analysis

Critical thinking

Attention to detail

Communication

Office software

Adaptability

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a skilled professional to support clinical quality member intervention activities across Medicare, Marketplace, Medicaid, and other lines of business. You will develop and implement interventions, monitor outcomes, and report results to leadership, ensuring regulatory compliance and continuous improvement.

Role involves building relationships with community organizations and evaluating interventions for effectiveness.