Senior Health Plan Interventions & Quality Lead

Molina Healthcare; Post Falls (ID); Remote; USD 49,000 - 96,000; Full time

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare is seeking a Senior Quality Interventions Specialist to support clinical quality member interventions across Medicare, Marketplace, and Medicaid. You will develop and implement intervention initiatives, monitor performance, and ensure alignment with NCQA standards.

Responsibilities include data collection, narrative reporting, documenting milestones, and collaborating with community-based organizations to enhance care quality. Travel 0–80% and multi-state needs may apply.

Qualifications

• 3+ years in health care; 2+ years in health plan quality interventions.
• Strong business writing experience.
• Proficient data analysis and interpretation.
• Knowledge of HEDIS and NCQA.
• Strong 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 environment.
• Effective verbal and written communication skills.

Responsibilities

• Implements evidence-based and data-informed member intervention strategies and manages interventions.
• Monitors completion of key activities and presents results to management and other departments.
• Writes narrative reports interpreting regulatory specifications and program results.
• Creates and compiles documentation to maintain milestones and deadlines.
• Participates in quality improvement activities and cross-department discussions.
• Supports partnerships with community-based organizations to improve care quality.
• Evaluates project activities to identify improvement opportunities.
• Raises gaps in processes to quality leadership and supports related projects.
• Provides training and support to team members.
• Adapts to change management and maintains a positive outlook.
• Travel may be required: 0-80% nationally; multi-day travel as needed.

Skills

Healthcare experience

Data analysis

Business writing

HEDIS/NCQA knowledge

Communication skills

Microsoft Office

Education

Registered Nurse license (RN)

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a Senior Quality Interventions Specialist to support clinical quality member interventions across Medicare, Marketplace, and Medicaid. You will develop and implement intervention initiatives, monitor performance, and ensure alignment with NCQA standards.

Responsibilities include data collection, narrative reporting, documenting milestones, and collaborating with community-based organizations to enhance care quality. Travel 0–80% and multi-state needs may apply.