Specialist, Quality Interventions/QI Compliance (Remote)

Lensa; Everett (WA); Remote; USD 80,000 - 100,000; Full time

Job summary

A leading career site is seeking a Specialist for Quality Interventions/QI Compliance. This role involves overseeing healthcare quality improvement initiatives, conducting data collection, and ensuring compliance with quality standards. The ideal candidate will have a Bachelor's degree and experience in healthcare quality improvement, with strong writing skills and operational knowledge of relevant tools.

Qualifications

• Minimum 3 years’ experience in healthcare, with 1 year in health plan quality improvement.
• Strong business writing skills required.
• Operational knowledge of Excel and Visio.

Responsibilities

• Implements key quality strategies and monitors quality activities.
• Writes narrative reports and manages documentation for quality functions.
• Leads quality improvement activities and identifies process gaps.

Skills

Business writing

Quality improvement

Data collection

Education

Bachelor's Degree

Field: Clinical Quality, Public Health, or Healthcare

Tools

Excel

Visio

Job description

Specialist, Quality Interventions/QI Compliance (Remote)

Lensa is the leading career site for job seekers at every stage of their career. Our client, Molina Healthcare, is seeking professionals. Apply via Lensa today!

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 prescribed quality standards, conducts data collection, reporting, and monitoring for key performance measurement activities, and provides direction and implementation of NCQA accreditation surveys and federal/state QI compliance activities.

Knowledge/Skills/Abilities

The Specialist, Quality Interventions/ QI Compliance contributes to quality improvement functions such as Quality Interventions and Quality Improvement Compliance.

• Implements key quality strategies, including provider, member, and community interventions, preparation for Quality Improvement Compliance surveys, and other federal and state quality activities.
• Monitors and ensures timely and accurate completion of key quality activities, presenting results to management and other departments.
• Writes narrative reports interpreting regulatory specifications, explaining programs, and documenting findings and limitations.
• Creates and manages documentation to maintain critical quality functions.
• Leads quality improvement activities, meetings, and discussions within the organization.
• Evaluates project and program activities to identify improvement opportunities.
• Identifies process gaps requiring remediation and reports them to management.
• Performs other tasks, duties, projects, and programs as assigned.

Job Qualifications

Required Education

Bachelor's Degree or equivalent combination of education and work experience.

Required Experience

• Minimum 3 years’ experience in healthcare, with 1 year in health plan quality improvement, managed care, or equivalent.
• Strong business writing skills.
• Operational knowledge of Excel and Visio (flow chart software).

Preferred Education

Field: Clinical Quality, Public Health, or Healthcare.

Preferred Experience

1 year of experience in Medicare and Medicaid.

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 position should apply through the intranet.

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

Additional Details

• Pay Range: $21.82 - $48.94/hour, depending on location, experience, education, and skills.
• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Quality Assurance
• Industry: IT Services and IT Consulting