Specialist, Quality Interventions/QI Compliance (Remote)

Lensa; Provo (UT); Remote; 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 managing compliance surveys, monitoring quality activities, and leading improvement discussions. Ideal candidates will have a Bachelor's degree and experience in healthcare quality improvement. Join a dynamic team committed to enhancing healthcare standards.

Benefits

Competitive Benefits Package

Qualifications

• At least 3 years’ experience in healthcare, with 1 year in health plan quality improvement.
• Strong business writing skills required.

Responsibilities

• Implements key quality strategies and manages quality compliance surveys.
• Monitors and ensures timely completion of quality activities.

Skills

Business Writing

Quality Improvement

Data Analysis

Education

Bachelor's Degree

Tools

Excel

Visio

Job description

Specialist, Quality Interventions/QI Compliance (Remote)

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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 for 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 management of provider, member, and community interventions, and preparation for Quality Improvement Compliance surveys.
• 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 results, 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 activities to identify opportunities for improvement.
• Identifies process gaps requiring remediation and reports to managers and directors.
• Performs other tasks and projects as assigned.

Job Qualifications

Required Education

Bachelor's Degree or equivalent experience.

Required Experience

• At least 3 years’ experience 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: 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 position should apply through the intranet.

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

Additional Details

• Pay Range: $21.82 - $48.94/hour

Job Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Quality Assurance
• Industries: IT Services and IT Consulting