Specialist, Member & Community Interventions - Quality / HEDIS (Remote in OH)

Molina Healthcare; Long Beach (CA); Remote; USD 50,000 - 70,000; Full time

Job summary

A leading healthcare provider in Long Beach is seeking a candidate for managing community interventions and quality improvement activities. The role requires an associate’s degree, healthcare experience, and strong business writing skills. Candidates with a bachelor's degree and relevant certifications will stand out. Join a supportive environment that positively impacts member health outcomes.

Benefits

Comprehensive benefits package

Career advancement opportunities

Qualifications

• 1-3 years’ experience in healthcare, focusing on member interventions.
• Experience in quality improvement activities.
• Knowledge of Medicare and Medicaid managed care preferred.

Responsibilities

• Implement evidence-based member intervention strategies.
• Monitor completion of member intervention activities.
• Write narrative reports interpreting regulatory specifications.

Skills

Business writing

Problem-solving

Operational knowledge of Excel

Operational knowledge of Visio

Education

Associate’s degree or equivalent

Bachelor’s Degree in relevant field

Job description

Why consider this job opportunity

• Opportunity for career advancement and growth within the organization
• Supportive and collaborative work environment
• Engage in meaningful work that positively impacts member health outcomes
• Potential for travel, allowing for diverse experiences in community interactions
• Comprehensive benefits and compensation package

What to Expect (Job Responsibilities)

• Implement evidence-based member intervention strategies and manage community interventions
• Monitor and ensure timely completion of key member intervention activities
• Write narrative reports to interpret regulatory specifications and document program findings
• Participate in quality improvement activities and collaborate with other departments
• Evaluate project activities to identify opportunities for improvement and support high-quality clinical care

What is Required (Qualifications)

• Associate’s degree or equivalent combination of education and work experience
• 1-3 years’ experience in healthcare with at least 1 year in health plan quality member interventions or managed care
• Demonstrated solid business writing experience
• Operational knowledge and experience with Excel and Visio
• Excellent problem-solving skills

How to Stand Out (Preferred Qualifications)

• Bachelor’s Degree in Nursing, Social Work, Clinical Quality, Public Health, or Healthcare Administration
• 1 year of experience in Medicare and Medicaid managed care
• Certified Professional in Health Quality (CPHQ)
• Nursing License (RN may be preferred for specific roles)
• Certified HEDIS Compliance Auditor (CHCA)

#HealthcareServices #MemberInterventions #QualityImprovement #CareerOpportunity #CommunityEngagement

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