Senior Health Plan & Community Interventions Lead

Molina Healthcare, Inc.; Boise (ID); Remoto; USD 70.000 - 95.000; Tempo pieno

Descrizione del lavoro

Molina Healthcare is seeking a senior specialist to lead and implement member intervention initiatives across Medicare, Marketplace, and Medicaid. You will develop data-informed strategies, monitor performance, and report outcomes to quality leadership to drive program improvements.

This role requires collaboration with care teams, regulators, and community organizations. The position emphasizes strong communication, analytical rigor, and problem-solving abilities, with flexibility for travel to

Competenze

• At least 3 years of healthcare experience, with at least 2 years in health plan quality interventions in a managed care setting.
• Demonstrated solid business writing experience.
• Proficiency with data analysis, manipulation and interpretation.
• Intermediate knowledge and understanding of HEDIS and NCQA.
• Critical-thinking, problem-solving and analytical skills.
• Attention to detail and organizational skills.
• Ability to navigate change with flexibility and a positive outlook.
• Ability to work independently in a fast-paced, deadline-driven environment.
• Effective verbal and written communication skills.
• Microsoft Office suite and applicable software programs proficiency, and ability to learn new information systems and software programs.

Mansioni

• Implements evidence-based and data-informed member intervention strategies including initiating and managing member and/or community interventions and other federal and state quality initiatives.
• Monitors and ensures key member intervention activities are completed on time and accurately, and presents results to department management and other Molina departments.
• Writes narrative reports to interpret regulatory specifications, explains programs and results of programs, and documents findings and limitations of interventions.
• Creates, manages, and/or compiles required documentation to maintain milestones, deadlines, and deliverables.
• Participates in quality improvement activities, meetings, and discussions with other departments.
• Supports provision of high-quality clinical care by facilitating/building strategic relationships with community-based organizations.
• Evaluates quality project activities and results to identify opportunities for improvement.
• Raises gaps in processes that may require remediation to quality leadership.
• Provides support for quality-related projects.
• Provides training and support to new and existing quality intervention team members.
• Demonstrates flexibility with change management and maintains a positive outlook.
• This position may require same day out of office travel 0 - 80% of time, and multi-day overnight travel on occasion.

Conoscenze

Health care experience

Data analysis

Business writing

HEDIS/NCQA knowledge

Problem solving

Attention to detail

Communication skills

Change management

Formazione

RN license (preferred)

CPHQ certification (preferred)

CHCA certification (preferred)

Strumenti

Microsoft Office

Descrizione del lavoro

Molina Healthcare is seeking a senior specialist to lead and implement member intervention initiatives across Medicare, Marketplace, and Medicaid. You will develop data-informed strategies, monitor performance, and report outcomes to quality leadership to drive program improvements.

This role requires collaboration with care teams, regulators, and community organizations. The position emphasizes strong communication, analytical rigor, and problem-solving abilities, with flexibility for travel to