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Facility Site Review Nurse

Long Beach, California Job ID 1904033
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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
Responsible for timely performance of Facility reviews and appropriate follow up for network practitioners in compliance with DHS requirements; NCQA Standards and Molina Policies and Procedures. Reports, letters and all follow up information must be submitted in compliance with set standards for content and timing requirements.

• Collaborates with practitioners and their staff, conveys Molina's commitment to assisting practitioners to comply with all federal, state and local regulations and related accrediting agency standards.
• Maintains confidentiality of data, communications and interactions, internally and externally.
• Updates and assistance in maintenance of Site Review Database, Report Preparation and submission within set Molina Standards.
• Participates in internal reviews, including, but not limited to, inter-rater reliability activities, designed to maintain consistency of work process.
• Presents problems and recommended solutions to Quality Improvement management

Qualifications

Job Qualifications



Required Education
Completion of an accredited Registered Nurse (RN) Program or Bachelor's in Nursing.
Required Experience
Minimum 3 years clinical experience.
Required License, Certification, Association
Active, unrestricted State Registered Nursing (RN) license in good standing.
Preferred Education
Bachelor of Science Degree in Nursing
Preferred Experience
1+ year of experience in Managed Care

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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