Specialist, Quality Interventions/QI Compliance (Remote)

Lensa; Salt Lake City (UT); Remote; Full time

Job summary

A leading healthcare organization is looking for a Quality Specialist to oversee and implement quality improvement initiatives. The role involves monitoring compliance, conducting data analysis, and leading quality activities across various departments. Ideal candidates will have a Bachelor's degree and significant healthcare experience. This position offers competitive pay and benefits.

Qualifications

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

Responsibilities

• Implements key quality strategies and monitors quality activities.
• Writes narrative reports interpreting regulatory specifications.
• Leads quality improvement activities across departments.

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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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 activities, and manages NCQA accreditation surveys and federal/state QI compliance activities.

Knowledge/Skills/Abilities

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

• Implements key quality strategies, such as 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 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 quality improvement functions.
• Leads quality improvement activities, meetings, and discussions across departments.
• Evaluates project activities and results to identify improvement opportunities.
• 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

• Minimum 3 years’ healthcare experience, including 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

1 year in Medicare and Medicaid.

Preferred Certifications

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

Interested Molina employees should apply through the intranet. Molina offers competitive benefits. EOE M/F/D/V.

Pay Range: $21.82 - $48.94/hour. Actual pay varies based on location, experience, education, and skills.

Additional Details

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

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