Senior Health Plan Interventions & Quality Lead

Molina Healthcare, Inc.; Idaho; Remote; USD 49,000 - 96,000; Full time

Job summary

Molina Healthcare, Inc. is seeking a senior-level professional to support clinical quality member interventions across Medicare, Marketplace, Medicaid and other lines of business.

You will develop and implement intervention initiatives, monitor outcomes, conduct data collection, and support continuous quality improvement in collaboration with multiple departments. The role requires strong writing, data analysis, and NCQA/HEDIS knowledge, with travel as needed to various states, and a commitment

Qualifications

• At least 3 years of health care experience and 2 years in health plan quality member interventions in a managed care setting or equivalent.
• 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 proficiency and ability to learn new information systems and software programs.

Responsibilities

• Implements evidence-based and data-informed intervention strategies across multiple lines of business.
• Monitors and ensures timely completion of intervention activities and presents results to management.
• Writes narrative reports interpreting regulatory specifications and program results.
• Maintains documentation for milestones, deadlines and deliverables.
• Participates in quality improvement activities and cross-department discussions.
• Supports community relationships to enhance quality of care.
• Evaluates activities to identify opportunities for improvement.
• Raises gaps in processes to quality leadership.
• Provides training and support to new and existing team members.
• Adapts to change and maintains a positive outlook.
• May require 0–80% travel, with occasional multi-day trips.

Skills

Health care experience

Quality interventions

Data analysis

HEDIS/NCQA knowledge

Attention to detail

Communication skills

Microsoft Office

Education

RN license

CPHQ certification

CHCA certification

Tools

Excel

EMR/health data systems

Job description

Molina Healthcare, Inc. is seeking a senior-level professional to support clinical quality member interventions across Medicare, Marketplace, Medicaid and other lines of business.

You will develop and implement intervention initiatives, monitor outcomes, conduct data collection, and support continuous quality improvement in collaboration with multiple departments. The role requires strong writing, data analysis, and NCQA/HEDIS knowledge, with travel as needed to various states, and a commitment