Manager, Health Plan 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- Care Review Clinician, Inpatient Review (RN) Cedar Rapids Iowa, Grand Island Nebraska, Ohio, Scottsdale Arizona, Dallas Texas, Meridian Idaho, Rio Rancho New Mexico, Buffalo New York, Racine Wisconsin, Orem Utah, Tacoma Washington, Des Moines Iowa, Florida, New York, Georgia, Warren Michigan, Tampa Florida, Louisville Kentucky, Santa Fe New Mexico, Sterling Heights Michigan, Akron Ohio, West Valley City Utah, Lincoln Nebraska, Kearney Nebraska, Augusta Georgia, Atlanta Georgia, Yonkers New York, Utah, Syracuse New York, Bowling Green Kentucky, Omaha Nebraska, Tucson Arizona, Kentucky, Idaho, Idaho Falls Idaho, Provo Utah, Michigan, Milwaukee Wisconsin, Kenosha Wisconsin, Lexington-Fayette Kentucky, Covington Kentucky, Green Bay Wisconsin, Spokane Washington, Columbus Ohio, Roswell New Mexico, Macon Georgia, Wisconsin, Vancouver Washington, Chandler Arizona, Mesa Arizona, Fort Worth Texas, Ann Arbor Michigan, Savannah Georgia, Sioux City Iowa, Nampa Idaho, Albany New York, Everett Washington, Boise Idaho, Cincinnati Ohio, Cleveland Ohio, Las Cruces New Mexico, Grand Rapids Michigan, Iowa City Iowa, Jacksonville Florida, Layton Utah, San Antonio Texas, Phoenix Arizona, Texas, St. Petersburg Florida, Austin Texas, Miami Florida, New Mexico, Detroit Michigan, Davenport Iowa, Bellevue Nebraska, Rochester New York, Washington, Orlando Florida, Iowa, Nebraska, Houston Texas, Albuquerque New Mexico, Madison Wisconsin, Salt Lake City Utah, Dayton Ohio, Bellevue Washington, Caldwell Idaho, Owensboro Kentucky, Columbus Georgia 05/22/2025
- Program Manager (Remote - Must Reside in California) San Francisco California, Los Angeles California, San Jose California, San Diego California, Sacramento California 05/09/2025
- Manager, Actuarial Services (Medicaid) - REMOTE Everett Washington, Albany New York, Ohio, Bellevue Washington, Bellevue Nebraska, Kearney Nebraska, Kenosha Wisconsin, New Mexico, Buffalo New York, Dayton Ohio, Sterling Heights Michigan, Rio Rancho New Mexico, Miami Florida, Covington Kentucky, Michigan, Las Cruces New Mexico, Orem Utah, Wisconsin, Tacoma Washington, Syracuse New York, Des Moines Iowa, Provo Utah, Owensboro Kentucky, Lexington-Fayette Kentucky, Cincinnati Ohio, Tucson Arizona, Savannah Georgia, Columbus Georgia, Macon Georgia, Green Bay Wisconsin, Albuquerque New Mexico, Seattle Washington, Nampa Idaho, Nebraska, Cedar Rapids Iowa, Bowling Green Kentucky, Augusta Georgia, Texas, Orlando Florida, Florida, Utah, Grand Rapids Michigan, Spokane Washington, Scottsdale Arizona, Grand Island Nebraska, Sioux City Iowa, Columbus Ohio, Caldwell Idaho, Phoenix Arizona, Tampa Florida, Yonkers New York, New York, Warren Michigan, Lincoln Nebraska, Detroit Michigan, Mesa Arizona, Louisville Kentucky, Akron Ohio, Santa Fe New Mexico, Washington, Jacksonville Florida, New York New York, Iowa City Iowa, Meridian Idaho, Chandler Arizona, Kentucky, Salt Lake City Utah, Ann Arbor Michigan, Houston Texas, Omaha Nebraska, Idaho Falls Idaho, Fort Worth Texas, Madison Wisconsin, Boise Idaho, Roswell New Mexico, Layton Utah, Austin Texas, Idaho, Iowa, St. Petersburg Florida, Rochester New York, Davenport Iowa, Vancouver Washington, Cleveland Ohio, Milwaukee Wisconsin, West Valley City Utah, Atlanta Georgia, Racine Wisconsin, San Antonio Texas, Dallas Texas, Georgia 04/29/2025
- Pharmacy Technician Everett Washington, Albany New York, New Mexico, Wisconsin, Idaho, New York, Texas, Kentucky, Nebraska, Ohio, Georgia, Utah, Florida, Michigan, Washington, Iowa, Warren Michigan, Bellevue Washington, Miami Florida, Bowling Green Kentucky, Bellevue Nebraska, Fort Worth Texas, Santa Fe New Mexico, Albuquerque New Mexico, West Valley City Utah, Des Moines Iowa, Columbus Georgia, Milwaukee Wisconsin, Green Bay Wisconsin, Jacksonville Florida, Salt Lake City Utah, Syracuse New York, Mesa Arizona, Houston Texas, Dayton Ohio, Augusta Georgia, Racine Wisconsin, Layton Utah, Provo Utah, Grand Rapids Michigan, Owensboro Kentucky, Davenport Iowa, Cedar Rapids Iowa, Cleveland Ohio, Columbus Ohio, Savannah Georgia, Macon Georgia, Yonkers New York, Covington Kentucky, Nampa Idaho, Chandler Arizona, Roswell New Mexico, Grand Island Nebraska, Sioux City Iowa, Akron Ohio, Madison Wisconsin, Boise Idaho, Orem Utah, Spokane Washington, Tampa Florida, Orlando Florida, Meridian Idaho, Idaho Falls Idaho, Phoenix Arizona, Louisville Kentucky, Dallas Texas, Rio Rancho New Mexico, Omaha Nebraska, Atlanta Georgia, Detroit Michigan, Tacoma Washington, St. Petersburg Florida, Rochester New York, Tucson Arizona, Lincoln Nebraska, Las Cruces New Mexico, Kenosha Wisconsin, Caldwell Idaho, Ann Arbor Michigan, Sterling Heights Michigan, Vancouver Washington, Buffalo New York, Lexington-Fayette Kentucky, Scottsdale Arizona, Austin Texas, San Antonio Texas, Kearney Nebraska, Iowa City Iowa, Cincinnati Ohio 04/25/2025
No recently viewed jobs.
View All JobsNo saved jobs.
View All Jobs