Specialist, Quality Interventions/QI Compliance (Remote)

Lensa; Bellevue (WA); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare organization is seeking a Specialist in Quality Interventions/QI Compliance to oversee quality improvement initiatives. This role involves implementing strategies, managing documentation, and ensuring compliance with quality standards. The ideal candidate will have a Bachelor's degree and experience in healthcare quality improvement.

Qualifications

• At least 3 years in healthcare with 1 year in health plan quality improvement or managed care.
• Experience in Medicare and Medicaid for 1 year.

Responsibilities

• Implementing key quality strategies and monitoring quality activities.
• Writing reports to interpret regulations and document findings.
• Leading quality improvement activities and discussions across departments.

Skills

Business writing skills

Operational knowledge of Excel

Operational knowledge of Visio

Education

Bachelor's Degree or equivalent experience

Field of study: Clinical Quality, Public Health, or Healthcare

Job description

Specialist, Quality Interventions/QI Compliance (Remote)

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Job Description

Job Summary

Molina's Quality Improvement function oversees, plans, and implements healthcare quality improvement initiatives and education programs. It ensures maintenance of programs for members in accordance with quality standards, conducts data collection, reporting, and monitoring for key performance activities, and manages NCQA accreditation surveys and QI compliance activities.

Knowledge/Skills/Abilities

The Specialist, Quality Interventions/QI Compliance contributes to quality improvement functions such as:

• Implementing key quality strategies, including management of provider, member, and community interventions.
• Monitoring and ensuring timely and accurate completion of quality activities.
• Writing reports to interpret regulations, explain programs, and document findings.
• Managing documentation for quality functions.
• Leading quality improvement activities and discussions across departments.
• Evaluating project outcomes to identify improvement opportunities.
• Reporting gaps in processes requiring remediation.
• Performing other assigned tasks and projects.

Job Qualifications

Required Education

Bachelor's Degree or equivalent experience.

Required Experience

• At least 3 years in healthcare with 1 year in health plan quality improvement or managed care.
• Strong business writing skills.
• Operational knowledge of Excel and Visio.

Preferred Education

Field of study: Clinical Quality, Public Health, or Healthcare.

Preferred Experience

Experience in Medicare and Medicaid for 1 year.

Preferred Certifications

• Certified Professional in Health Quality (CPHQ)
• Nursing License (RN preferred for some roles)
• Certified HEDIS Compliance Auditor (CHCA)

Current Molina employees interested in this role should apply through the intranet.

Molina Healthcare offers competitive benefits. We are an Equal Opportunity Employer (EOE) M/F/D/V.

Additional Details

• Pay Range: $21.82 - $48.94/hour
• Seniority Level: Mid-Senior level
• Employment Type: Full-time
• Job Function: Quality Assurance
• Industries: IT Services and IT Consulting