Senior Health Plan Interventions Lead

Molina Healthcare, Inc.; Nampa (ID); Remote; USD 49,000 - 96,000; Full time

Job summary

Molina Healthcare, Inc. is seeking a senior-level professional to support clinical quality member intervention activities across Medicare, Marketplace, Medicaid, and more. You will develop and implement interventions, monitor outcomes, and ensure compliance with NCQA and federal/state regulations.

Responsibilities include data collection, reporting results, and building collaborations with community-based organizations to improve care quality. Some travel may be required depending on state needs.

Qualifications

• At least 3 years of experience in health care and 2 years in health plan quality interventions.
• Solid business writing experience.
• Proficiency with data analysis and interpretation.
• Knowledge of HEDIS and NCQA.
• Strong critical-thinking, problem-solving and analytical skills.
• Attention to detail and organizational skills.
• Ability to navigate change with a positive outlook.
• Ability to work independently in a fast-paced environment.
• Effective verbal and written communication; proficient with MS Office.

Responsibilities

• Implement evidence-based member intervention strategies and manage programs across lines of business.
• Monitor completion, present results to management and other departments.
• Write narrative reports interpreting regulatory specs and program results.
• Create and maintain required documentation for milestones and deadlines.
• Participate in quality improvement activities and cross-department discussions.
• Support quality-related projects and build relationships with community organizations.
• Evaluate activities to identify improvement opportunities and raise gaps to leadership.
• Provide training and support to team members; adapt to changes.

Skills

Business writing

Data analysis

HEDIS/NCQA knowledge

Critical thinking

Attention to detail

Change management

Independent work

Communication skills

Microsoft Office

Tools

Microsoft Office

Job description

Molina Healthcare, Inc. is seeking a senior-level professional to support clinical quality member intervention activities across Medicare, Marketplace, Medicaid, and more. You will develop and implement interventions, monitor outcomes, and ensure compliance with NCQA and federal/state regulations.

Responsibilities include data collection, reporting results, and building collaborations with community-based organizations to improve care quality. Some travel may be required depending on state needs.