Specialist, Quality Interventions/QI Compliance (Remote)

Lensa; Spokane (WA); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading company in healthcare is seeking a Specialist in Quality Interventions/QI Compliance. This role focuses on implementing quality improvement initiatives, ensuring compliance with healthcare standards, and managing documentation. Candidates should have a Bachelor's Degree and relevant experience in quality improvement within healthcare settings.

Qualifications

• At least 3 years in healthcare, with 1 year in health plan quality improvement or managed care.
• Strong business writing skills.
• Operational knowledge of Excel and Visio.

Responsibilities

• Implementing key quality strategies and preparing for compliance surveys.
• Monitoring and ensuring timely completion of quality activities.
• Writing narrative reports to interpret regulations and document findings.

Skills

Business writing

Quality improvement

Data collection

Monitoring

Education

Bachelor's Degree or equivalent experience

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 according to prescribed quality standards, conducts data collection, reporting, 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:

• Implementing key quality strategies such as provider, member, and community interventions, and preparing for Quality Improvement Compliance surveys.
• Monitoring and ensuring timely and accurate completion of quality activities.
• Writing narrative reports to interpret regulations, explain programs, and document findings.
• Creating and managing documentation for quality functions.
• Leading quality improvement activities and meetings across departments.
• Evaluating projects to identify improvement opportunities.
• Reporting process gaps requiring remediation.
• Performing additional tasks as assigned.

Job Qualifications

Required Education

Bachelor's Degree or equivalent experience.

Required Experience

• At least 3 years 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 of study: 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 specific roles)
• Certified HEDIS Compliance Auditor (CHCA)

Current Molina employees interested in this role should apply via the intranet.

Molina Healthcare offers competitive benefits and is an EOE M/F/D/V.

Additional Details

• Pay Range: $21.82 - $48.94/hour, varies by location, experience, and skills.

Job Details

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

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