Senior Health Plan Quality & Performance Lead

Molina Healthcare; Bothell (WA); A distancia; USD 90.000 - 120.000; Jornada completa

Descripción de la vacante

Molina Healthcare in Bothell, WA seeks a Sr. Quality Management Nurse to support quality programs, audits, and state/federal compliance.

You will drive clinical quality improvements, participate in credentialing processes, and collaborate across departments to ensure safe, cost-effective member care. The role requires a Registered Nurse license, 3+ years in healthcare with 1+ year in quality management, and strong data analysis and communication skills.

Formación

• At least 3 years in health care with 1 year in quality management/clinical investigations.
• Active RN license in state of practice; managed care experience preferred.

Responsabilidades

• Provides senior level clinical support to quality team and contributes to quality programs, audits, and compliance activities.
• Performs quality monitoring including audits of medical record quality and safety.
• Monitors and communicates quality activities to leadership; supports policy/procedure updates.
• Supports credentialing/recredentialing and peer review activities.
• Identifies gaps in processes and collaborates with leadership to implement improvements.
• Ensures documentation aligns with state requirements and standard workflows.

Conocimientos

Quality management

HEDIS/NCQA knowledge

Quality investigations

Policy development

Cross-functional collaboration

Data analysis

Communication

MS Office

Educación

Registered Nurse License

Herramientas

Microsoft Office

Descripción del empleo

Molina Healthcare in Bothell, WA seeks a Sr. Quality Management Nurse to support quality programs, audits, and state/federal compliance.

You will drive clinical quality improvements, participate in credentialing processes, and collaborate across departments to ensure safe, cost-effective member care. The role requires a Registered Nurse license, 3+ years in healthcare with 1+ year in quality management, and strong data analysis and communication skills.