Senior Health Plan Quality & Member Interventions Lead

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

Job summary

Molina Healthcare is seeking a senior specialist to support clinical quality member interventions across Medicare, Marketplace and Medicaid. You will implement data-informed strategies, monitor program activities, and prepare narrative reports that interpret regulatory standards and program results.

You will contribute to quality improvement initiatives, document milestones, and collaborate with departments and community-based organizations to drive high-quality care.

Qualifications

• 3+ years in healthcare with 2+ years in health plan quality interventions in a managed care setting or equivalent experience.
• Demonstrated solid business writing experience.
• Proficiency with data analysis, manipulation and interpretation.
• Knowledge of HEDIS and NCQA standards.

Responsibilities

• Implements evidence-based and data-informed member interventions and other quality initiatives.
• Monitors timely, accurate completion of intervention activities and presents results to management.
• Writes narratives interpreting regulatory specifications and program results.
• Creates and maintains documentation to meet milestones and deliverables.
• Supports quality improvement activities and cross-department collaboration.
• Builds relationships with community-based organizations to support quality care.

Skills

Healthcare experience

Quality improvement

Data analysis

HEDIS/NCQA knowledge

Business writing

Communication skills

Problem solving

Attention to detail

Change management

Independent work

Tools

Microsoft Office Suite

Job description

Molina Healthcare is seeking a senior specialist to support clinical quality member interventions across Medicare, Marketplace and Medicaid. You will implement data-informed strategies, monitor program activities, and prepare narrative reports that interpret regulatory standards and program results.

You will contribute to quality improvement initiatives, document milestones, and collaborate with departments and community-based organizations to drive high-quality care.