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Molina Healthcare Specialist, Quality Interventions/QI Compliance- Remote in Iowa

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.

This position may require same day out of office travel approximately 0 - 50% of the time, depending upon location.

This position may require multiple day out of town overnight travel approximately 0 - 20% of the time, depending upon location.

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)

  • Nursing License (RN may be preferred for specific roles)

  • 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 - $51.06 / HOURLY

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

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