HEDIS / QI InterventionsMolina Healthcare Houston, Texas Job ID 2009791
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.
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 in order 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..
Bachelor's Degree or equivalent combination of education and work 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).
Required License, Certification, Association
Preferred field: Clinical Quality, Public Health or Healthcare.
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.
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: Full Time Posting Date: 10/06/2021
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