Specialist, Quality Interventions/QI Compliance (Remote)

Molina Healthcare; Provo (UT); Remote; USD 60,000 - 80,000; Full time

Job summary

An established industry player in healthcare is seeking a Quality Improvement Specialist to oversee and implement quality initiatives. This role involves managing quality compliance activities, conducting data analysis, and leading improvement programs that enhance patient care. The ideal candidate will have a strong background in healthcare quality, excellent writing skills, and proficiency in essential tools like Excel and Visio. Join a dynamic team dedicated to improving health outcomes and ensuring compliance with regulatory standards, all while enjoying a competitive compensation package and a supportive work environment.

Qualifications

• 3+ years in healthcare with 1 year in quality improvement or managed care.
• Strong business writing and operational skills required.

Responsibilities

• Implement key quality strategies and manage healthcare interventions.
• Monitor quality activities and report results to management.
• Lead quality improvement meetings and evaluate project outcomes.

Skills

Quality Improvement Compliance

Data Collection and Reporting

Business Writing

Project Evaluation

Intervention Management

Education

Bachelor's Degree

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.

1. 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.
2. 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.
3. Writes narrative reports to interpret regulatory specifications, explain programs and results of programs, and document findings and limitations of department interventions.
4. Creates, manages, and/or compiles the required documentation to maintain critical quality improvement functions.
5. Leads quality improvement activities, meetings, and discussions with and between other departments within the organization.
6. Evaluates project/program activities and results to identify opportunities for improvement.
7. Surfaces to Manager and Director any gaps in processes that may require remediation.
8. 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

1. Min. 3 years’ experience in healthcare with 1 year experience in health plan quality improvement, managed care, or equivalent experience.
2. Demonstrated solid business writing experience.
3. 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

1. Certified Professional in Health Quality (CPHQ)
2. Nursing License (RN may be preferred for specific roles)
3. Certified HEDIS Compliance Auditor (CHCA)

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

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 - $48.94 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.