Senior Health Plan Intervention & Quality Lead

Molina Healthcare; Iowa (LA); On-site; USD 52,000 - 95,000; Full time

Job summary

Molina Healthcare is seeking a senior-level professional to support clinical quality member intervention activities across Medicare, Marketplace, and Medicaid, ensuring alignment with NCQA regulations and program standards.

You will conduct data collection, monitor activities, and report outcomes to facilitate continuous improvement of intervention processes and outcomes, while building relationships with community-based organizations.

Qualifications

• At least 3 years of health care experience and at least 2 years in health plan quality member interventions in a managed care setting.
• Demonstrated solid business writing experience and data analysis skills; knowledge of HEDIS/NCQA is a plus.
• Strong communication, problem-solving and organizational abilities; ability to adapt to change.

Responsibilities

• Support development and implementation of member/ community intervention initiatives.
• Monitor intervention activities and report outcomes to management.
• Collaborate with other departments and external organizations to improve quality initiatives.
• Travel as needed (0-80% same day; occasional multi-day) depending on state-specific needs.

Skills

Health care experience

Data analysis

Communication skills

Attention to detail

Change management

Independent work

Education

RN license

CPHQ

CHCA

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a senior-level professional to support clinical quality member intervention activities across Medicare, Marketplace, and Medicaid, ensuring alignment with NCQA regulations and program standards.

You will conduct data collection, monitor activities, and report outcomes to facilitate continuous improvement of intervention processes and outcomes, while building relationships with community-based organizations.