Manager, Clinical Quality Interventions - RN Required (Remote)
Molina Healthcare Kearney, Nebraska; Des Moines, Iowa; Albuquerque, New Mexico; Layton, Utah; Washington; Utah; Iowa City, Iowa; Milwaukee, Wisconsin; Orlando, Florida; Augusta, Georgia; Fort Worth, Texas; Chandler, Arizona; Phoenix, Arizona; Green Bay, Wisconsin; West Valley City, Utah; Savannah, Georgia; Provo, Utah; Atlanta, Georgia; Louisville, Kentucky; Warren, Michigan; Tampa, Florida; Santa Fe, New Mexico; Syracuse, New York; San Antonio, Texas; Texas; New York; Nebraska; Idaho; Georgia; Michigan; Scottsdale, Arizona; Bellevue, Nebraska; Rochester, New York; Columbus, Georgia; Roswell, New Mexico; Kenosha, Wisconsin; Wisconsin; Ohio; Tacoma, Washington; St. Petersburg, Florida; Lincoln, Nebraska; Buffalo, New York; Salt Lake City, Utah; Sterling Heights, Michigan; Covington, Kentucky; Omaha, Nebraska; Davenport, Iowa; Houston, Texas; Spokane, Washington; Everett, Washington; Albany, New York; Boise, Idaho; Macon, Georgia; Miami, Florida; Detroit, Michigan; Cedar Rapids, Iowa; Mesa, Arizona; Grand Rapids, Michigan; Lexington-Fayette, Kentucky; Madison, Wisconsin; Bowling Green, Kentucky; Orem, Utah; Sioux City, Iowa; Yonkers, New York; Tucson, Arizona; Cincinnati, Ohio; Cleveland, Ohio; Ann Arbor, Michigan; Racine, Wisconsin; Dayton, Ohio; New Mexico; Dallas, Texas; Iowa; Florida; Vancouver, Washington; Owensboro, Kentucky; Rio Rancho, New Mexico; Columbus, Ohio; Meridian, Idaho; Las Cruces, New Mexico; Akron, Ohio; Jacksonville, Florida; Kentucky; Nampa, Idaho; Grand Island, Nebraska; Idaho Falls, Idaho; Austin, Texas; Bellevue, Washington; Caldwell, Idaho Job ID 2031611JOB 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. Â
Only individuals with an RN license are being considered at this time.Â
- 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
Active, unrestricted RN License. Â
Required Experience
5+ years' experience in managed healthcare, including at least 2 years in health plan quality improvement or equivalent/related experience.
2+ years' management experience leading a healthcare quality team. Â
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)
- 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: $77,969 - $155,508 / 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: Full Time Posting Date: 04/23/2025ABOUT OUR LOCATION
View Map- Pega Principal Engineer, Applications Buffalo New York, Milwaukee Wisconsin, Albany New York, Omaha Nebraska, Michigan, Ohio, Nebraska, Washington, New Mexico, Idaho, Texas, Rochester New York, Covington Kentucky, Grand Island Nebraska, Kenosha Wisconsin, Iowa City Iowa, Phoenix Arizona, Idaho Falls Idaho, Houston Texas, Bellevue Washington, Warren Michigan, Cincinnati Ohio, Columbus Ohio, Ann Arbor Michigan, Provo Utah, Salt Lake City Utah, Lexington-Fayette Kentucky, Everett Washington, Bellevue Nebraska, Tucson Arizona, Roswell New Mexico, West Valley City Utah, Chandler Arizona, Mesa Arizona, Des Moines Iowa, Albuquerque New Mexico, Syracuse New York, Las Cruces New Mexico, Meridian Idaho, Utah, Caldwell Idaho, Florida, Wisconsin, Tacoma Washington, Columbus Georgia, Cleveland Ohio, Macon Georgia, St. Petersburg Florida, Akron Ohio, Jacksonville Florida, New York, Layton Utah, Kearney Nebraska, Sioux City Iowa, Bowling Green Kentucky, Vancouver Washington, Scottsdale Arizona, Orlando Florida, Spokane Washington, Davenport Iowa, Kentucky, Yonkers New York, Iowa, Sterling Heights Michigan, Georgia, Cedar Rapids Iowa, Boise Idaho, Savannah Georgia, Atlanta Georgia, Detroit Michigan, Fort Worth Texas, Augusta Georgia, Nampa Idaho, Green Bay Wisconsin, Louisville Kentucky, Rio Rancho New Mexico, Racine Wisconsin, Dayton Ohio, Madison Wisconsin, Dallas Texas, San Antonio Texas, Austin Texas, Owensboro Kentucky, Orem Utah, Grand Rapids Michigan, Lincoln Nebraska, Miami Florida, Tampa Florida, Santa Fe New Mexico 04/30/2025
- Pharmacy Technician, Clinical/MTM Everett Washington, Albany New York, Milwaukee Wisconsin, Owensboro Kentucky, Omaha Nebraska, Cedar Rapids Iowa, Racine Wisconsin, San Antonio Texas, Idaho Falls Idaho, Salt Lake City Utah, Grand Rapids Michigan, Cincinnati Ohio, Iowa, Mesa Arizona, Texas, Fort Worth Texas, Columbus Ohio, Louisville Kentucky, St. Petersburg Florida, New York, Nebraska, Washington, Albuquerque New Mexico, Syracuse New York, Madison Wisconsin, Scottsdale Arizona, Spokane Washington, Phoenix Arizona, Cleveland Ohio, Yonkers New York, Bellevue Washington, Las Cruces New Mexico, Sterling Heights Michigan, Tacoma Washington, Green Bay Wisconsin, Davenport Iowa, Wisconsin, Dallas Texas, Warren Michigan, New York New York, Georgia, Roswell New Mexico, Augusta Georgia, Detroit Michigan, Dayton Ohio, Jacksonville Florida, Bellevue Nebraska, Caldwell Idaho, Buffalo New York, Savannah Georgia, Lincoln Nebraska, Tampa Florida, Kenosha Wisconsin, Florida, Michigan, Des Moines Iowa, Iowa City Iowa, Akron Ohio, Layton Utah, Orem Utah, Provo Utah, West Valley City Utah, Covington Kentucky, Utah, Ohio, Meridian Idaho, Santa Fe New Mexico, Rio Rancho New Mexico, Tucson Arizona, Kearney Nebraska, Rochester New York, Atlanta Georgia, Miami Florida, Orlando Florida, Macon Georgia, Austin Texas, Kentucky, New Mexico, Chandler Arizona, Idaho, Vancouver Washington, Houston Texas, Grand Island Nebraska, Boise Idaho, Lexington-Fayette Kentucky, Nampa Idaho, Sioux City Iowa, Ann Arbor Michigan, Seattle Washington, Columbus Georgia, Bowling Green Kentucky 05/01/2025
- Rep, Customer Experience Iowa City Iowa, Washington, Florida, Utah, Wisconsin, Texas, Iowa, New York, Arizona, Kentucky, Georgia, Ohio, Idaho, Nebraska, New Mexico, Michigan 05/01/2025
- Sr Analyst, Healthcare Analytics - Risk Adjustment (REMOTE) Everett Washington, Albany New York, Rochester New York, Orlando Florida, Yonkers New York, Idaho Falls Idaho, Milwaukee Wisconsin, Phoenix Arizona, Florida, Nampa Idaho, Columbus Ohio, Atlanta Georgia, Macon Georgia, Santa Fe New Mexico, Madison Wisconsin, Kentucky, Covington Kentucky, Ann Arbor Michigan, Tacoma Washington, Augusta Georgia, Provo Utah, Orem Utah, Nebraska, Caldwell Idaho, Boise Idaho, Albuquerque New Mexico, Sioux City Iowa, Dallas Texas, Cincinnati Ohio, Louisville Kentucky, Rio Rancho New Mexico, Kearney Nebraska, Miami Florida, Grand Island Nebraska, Cleveland Ohio, Michigan, Bellevue Nebraska, Syracuse New York, Washington, Wisconsin, Lexington-Fayette Kentucky, Sterling Heights Michigan, Detroit Michigan, New York New York, Bowling Green Kentucky, Iowa, Houston Texas, Las Cruces New Mexico, Savannah Georgia, Lincoln Nebraska, Salt Lake City Utah, Racine Wisconsin, Kenosha Wisconsin, Scottsdale Arizona, Owensboro Kentucky, Warren Michigan, St. Petersburg Florida, Davenport Iowa, Chandler Arizona, Akron Ohio, Vancouver Washington, Layton Utah, Utah, New York, Austin Texas, Bellevue Washington, Buffalo New York, Idaho, Texas, New Mexico, Seattle Washington, Omaha Nebraska, Tampa Florida, Iowa City Iowa, Des Moines Iowa, Columbus Georgia, Tucson Arizona, Cedar Rapids Iowa, Jacksonville Florida, Spokane Washington, San Antonio Texas, Ohio, Georgia, Grand Rapids Michigan, West Valley City Utah, Meridian Idaho, Green Bay Wisconsin, Mesa Arizona, Dayton Ohio, Roswell New Mexico, Fort Worth Texas 05/01/2025
No recently viewed jobs.
View All JobsNo saved jobs.
View All Jobs