Manager, Health Plan Quality Interventions (Remote)
Molina Healthcare Albany, New York; Everett, Washington; Layton, Utah; Orem, Utah; Warren, Michigan; Tampa, Florida; Syracuse, New York; Florida; Texas; Augusta, Georgia; Madison, Wisconsin; Kearney, Nebraska; Milwaukee, Wisconsin; Akron, Ohio; Roswell, New Mexico; Ann Arbor, Michigan; Sterling Heights, Michigan; Mesa, Arizona; Houston, Texas; Miami, Florida; Wisconsin; Columbus, Ohio; Caldwell, Idaho; Davenport, Iowa; San Antonio, Texas; Tucson, Arizona; Salt Lake City, Utah; Tacoma, Washington; Scottsdale, Arizona; Detroit, Michigan; Iowa; Owensboro, Kentucky; Louisville, Kentucky; Savannah, Georgia; Macon, Georgia; Kenosha, Wisconsin; Phoenix, Arizona; Las Cruces, New Mexico; West Valley City, Utah; Cleveland, Ohio; St. Petersburg, Florida; Jacksonville, Florida; Provo, Utah; Rio Rancho, New Mexico; Rochester, New York; Covington, Kentucky; Bowling Green, Kentucky; Boise, Idaho; Green Bay, Wisconsin; Des Moines, Iowa; Nampa, Idaho; Albuquerque, New Mexico; Idaho Falls, Idaho; Buffalo, New York; Kentucky; Utah; Lexington-Fayette, Kentucky; Nebraska; Idaho; New York; Columbus, Georgia; Omaha, Nebraska; Grand Island, Nebraska; Sioux City, Iowa; Iowa City, Iowa; Cincinnati, Ohio; Spokane, Washington; Orlando, Florida; New York, New York; Michigan; Washington; Bellevue, Nebraska; Racine, Wisconsin; Lincoln, Nebraska; Meridian, Idaho; Grand Rapids, Michigan; Bellevue, Washington; Seattle, Washington; Vancouver, Washington; Yonkers, New York; Ohio; Georgia; Dallas, Texas; Santa Fe, New Mexico; Fort Worth, Texas; New Mexico; Atlanta, Georgia; Cedar Rapids, Iowa; Chandler, Arizona; Dayton, Ohio; Austin, Texas Job ID 2031414JOB 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 Manager, Health Plan Quality Interventions is responsible for developing, implementing, and monitoring the success of quality improvement interventions. The Manager works to coordinate resources and training within the health plan and identify barriers to established goals and timelines. Key activities include implementing, monitoring, and analyzing the effectiveness of a comprehensive intervention strategy; and facilitating stakeholder input and strategic direction from the interventions Joint Operations Committee that includes leadership from multi-functional areas. The Manager serves as the primary contact for health plan interventions and leads the interventions Joint Operations Committee representing the Molina Plan Senior Leadership Team. In all activities, the Manager works with the national and regional collaborative analytics and strategic team to present and evaluate intervention strategies.
- Plans and/or implements Quality interventions that meet state and federal intervention rules and are aligned with effective practices as identified in the healthcare quality improvement literature and within Molina plans.
- Develops and implements targeted interventions related to performance improvement, including member and provider outreach to improve care and service.Â
- Serves as operations and implementation lead for Molina Plan quality improvement interventions using a defined roadmap, timeline, and key performance indicators.
- Collaborates with the national intervention collaborative analytics and strategic teams to deliver proposed interventions for review and evaluation.
- Communicates with the Molina Plan Senior Leadership Team, including the Plan President, Chief Medical Officer, national intervention collaborative analytics and strategic teams about key deliverables, timelines, barriers, and escalated issues that need immediate attention.
- Presents concise summaries, key takeaways, and action steps about Molina plan intervention strategy to national, regional and plan meetings.
- Demonstrates ability to lead and influence cross-functional teams that oversee implementation of quality interventions.
- Possesses a strong knowledge in quality to implement effective interventions that drive change.
- Functions as key lead for interventions including qualitative analysis, reporting and development of program materials, templates, or policies.Â
- Provides on-going support to manage and maintain the integrity of established programs/processes and member/provider outreach initiatives.
- Supports provision of high-quality clinical care and services by facilitating/building strategic relationships with health care providers.
JOB QUALIFICATIONS
Required Education
Bachelor's Degree or equivalent work experience.
Required Experience
- 5+ years' experience in managed healthcare, including at least 2 years in health plan quality improvement or equivalent/related experience.
- Operational knowledge and experience with Excel and Visio (flow chart equivalent).
Preferred Education
Master's Degree or higher in a clinical field, Public Health or Healthcare.
Preferred Experience
- 3+ years' experience with member/ provider (HEDIS) outreach and/or quality intervention or improvement studies (development, implementation, evaluation).
- Supervisory experience.
- Project management and team building experience.
- Experience developing performance measures that support business objectives.
- 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.
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Pay Range: $77,969 - $129,590 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type: Posting Date: 04/23/2025ABOUT OUR LOCATION
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- Manager, Health Plan Quality Interventions (Remote) Albany New York, Everett Washington, Layton Utah, Orem Utah, Warren Michigan, Tampa Florida, Syracuse New York, Florida, Texas, Augusta Georgia, Madison Wisconsin, Kearney Nebraska, Milwaukee Wisconsin, Akron Ohio, Roswell New Mexico, Ann Arbor Michigan, Sterling Heights Michigan, Mesa Arizona, Houston Texas, Miami Florida, Wisconsin, Columbus Ohio, Caldwell Idaho, Davenport Iowa, San Antonio Texas, Tucson Arizona, Salt Lake City Utah, Tacoma Washington, Scottsdale Arizona, Detroit Michigan, Iowa, Owensboro Kentucky, Louisville Kentucky, Savannah Georgia, Macon Georgia, Kenosha Wisconsin, Phoenix Arizona, Las Cruces New Mexico, West Valley City Utah, Cleveland Ohio, St. Petersburg Florida, Jacksonville Florida, Provo Utah, Rio Rancho New Mexico, Rochester New York, Covington Kentucky, Bowling Green Kentucky, Boise Idaho, Green Bay Wisconsin, Des Moines Iowa, Nampa Idaho, Albuquerque New Mexico, Idaho Falls Idaho, Buffalo New York, Kentucky, Utah, Lexington-Fayette Kentucky, Nebraska, Idaho, New York, Columbus Georgia, Omaha Nebraska, Grand Island Nebraska, Sioux City Iowa, Iowa City Iowa, Cincinnati Ohio, Spokane Washington, Orlando Florida, New York New York, Michigan, Washington, Bellevue Nebraska, Racine Wisconsin, Lincoln Nebraska, Meridian Idaho, Grand Rapids Michigan, Bellevue Washington, Seattle Washington, Vancouver Washington, Yonkers New York, Ohio, Georgia, Dallas Texas, Santa Fe New Mexico, Fort Worth Texas, New Mexico, Atlanta Georgia, Cedar Rapids Iowa, Chandler Arizona, Dayton Ohio, Austin Texas 04/23/2025
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- Dir, Configuration Albany New York, Everett Washington, Idaho, Texas, New York, Iowa, Nebraska, Washington, Georgia, Florida, Utah, Ohio, West Valley City Utah, Scottsdale Arizona, Miami Florida, Fort Worth Texas, Santa Fe New Mexico, Sterling Heights Michigan, Detroit Michigan, Milwaukee Wisconsin, Cedar Rapids Iowa, Savannah Georgia, Louisville Kentucky, Lincoln Nebraska, Grand Island Nebraska, Austin Texas, Grand Rapids Michigan, Provo Utah, Chandler Arizona, Augusta Georgia, Atlanta Georgia, Omaha Nebraska, Iowa City Iowa, Kearney Nebraska, Rochester New York, Roswell New Mexico, Bowling Green Kentucky, Lexington-Fayette Kentucky, Orem Utah, Seattle Washington, Orlando Florida, Green Bay Wisconsin, Columbus Ohio, Buffalo New York, Caldwell Idaho, Boise Idaho, Idaho Falls Idaho, Columbus Georgia, Kenosha Wisconsin, Des Moines Iowa, Cleveland Ohio, Davenport Iowa, Covington Kentucky, Salt Lake City Utah, Mesa Arizona, San Antonio Texas, Kentucky, New Mexico, Dallas Texas, Nampa Idaho, Madison Wisconsin, Dayton Ohio, Sioux City Iowa, Vancouver Washington, Spokane Washington, Jacksonville Florida, Tampa Florida, Syracuse New York, Ann Arbor Michigan, Warren Michigan, Phoenix Arizona, Bellevue Washington, Cincinnati Ohio, Yonkers New York, Owensboro Kentucky, Layton Utah, St. Petersburg Florida, Houston Texas, Macon Georgia, Akron Ohio, Wisconsin, Michigan, New York New York, Albuquerque New Mexico, Tucson Arizona, Meridian Idaho, Tacoma Washington, Racine Wisconsin, Bellevue Nebraska, Las Cruces New Mexico, Rio Rancho New Mexico 04/23/2025
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