Specialist, Quality Interventions/QI Compliance (Remote)

Molina Healthcare; Miami (FL); Remote; USD 100,000 - 125,000; Full time

Job summary

A leading healthcare provider is seeking a Specialist, Quality Interventions/ QI Compliance to oversee healthcare quality improvement initiatives. This role involves implementing strategies, monitoring quality activities, and writing reports. The ideal candidate will have at least 3 years of healthcare experience, including quality improvement, along with a bachelor's degree. Competitive pay rate and benefits are offered, with a focus on equal opportunities.

Benefits

Competitive benefits and compensation package

Qualifications

• Minimum 3 years’ experience in healthcare with 1 year in quality improvement.
• Demonstrated solid business writing experience.
• Knowledge of Medicare and Medicaid programs.

Responsibilities

• Implement key quality strategies and interventions.
• Monitor and ensure quality activities are completed accurately.
• Write narrative reports interpreting regulatory specifications.
• Create and manage documentation for quality functions.

Skills

Healthcare quality improvement

Data collection and reporting

Business writing

Quality Interventions management

Operational knowledge of Excel

Operational knowledge of Visio

Education

Bachelor's Degree or equivalent

Preferred field: Clinical Quality, Public Health or Healthcare

Tools

Excel

Visio

Job description

JOB DESCRIPTION

Job Summary

Molina's Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; 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 one or more of these quality improvement functions: Quality Interventions and Quality Improvement Compliance.

• Implements key quality strategies, which may include initiation and management of provider, member and/or community interventions (e.g., removing barriers to care); preparation for Quality Improvement Compliance surveys; and other federal and state required quality activities.
• Monitors and ensures that key quality activities are completed on time and accurately to present results to key departmental management and other Molina departments as needed.
• Writes narrative reports to interpret regulatory specifications, explain programs and results of programs, and document findings and limitations of department interventions.
• Creates, manages, and/or compiles the required documentation to maintain critical quality improvement functions.
• Leads quality improvement activities, meetings, and discussions with and between other departments within the organization.
• Evaluates project/program activities and results to identify opportunities for improvement.
• Surfaces to Manager and Director any gaps in processes that may require remediation.
• 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

• Min. 3 years’ experience in healthcare with 1 year experience in health plan quality improvement, managed care, or equivalent experience.
• Demonstrated solid business writing experience.
• Operational knowledge and experience with Excel and Visio (flow chart equivalent).

Preferred Education

Preferred field: Clinical Quality, Public Health or Healthcare.

Preferred Experience

1 year of experience in Medicare and in Medicaid.

Preferred License, Certification, Association

• Certified Professional in Health Quality (CPHQ)
• Certified HEDIS Compliance Auditor (CHCA)

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

Pay Range: $21.82 - $42.55 / HOURLY

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.