Specialist, Quality Interventions / QI Compliance (Remote)

Remote, USA Full-time
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 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 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. JOB QUALIFICATIONS Required Education Bachelor's Degree or equivalent combination of education and work experience. Required 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). Preferred Education Preferred field : Clinical Quality, Public Health or Healthcare. Preferred Experience 1 year of experience in Medicare and in Medicaid. 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 : $21.82 - $42.55 / HOURLY • Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.
Apply Now

Similar Jobs

Authorization Specialist, FT-Remote work eligibility base on experience & department needs

Remote, USA Full-time

**Experienced Part-Time Live Chat Representative – Automotive Industry Expertise Preferred**

Remote, USA Full-time

Registered Behavior Technician Training Program - Home Based - Reno/Sparks/Carso

Remote, USA Full-time

**Experienced Customer Support Chat Operator – blithequark – Jackson, MS 39201**

Remote, USA Full-time

**Experienced Customer Experience Chatroom Operator – Conversational SMS Platform Support**

Remote, USA Full-time

In-Home Autism Behavior Support Specialist (Become an RBT) - Greater Cleveland

Remote, USA Full-time

**Experienced Full Stack Software Engineer – Chat Widget Development and Optimization**

Remote, USA Full-time

RBT (Home-Based ABA, Experience Required)

Remote, USA Full-time

**Senior UI/UX Designer to Elevate Chat-Based Cannabis Product Info App at blithequark**

Remote, USA Full-time

**Experienced Online Chat Specialist – Customer Support and Relationship Building**

Remote, USA Full-time

The location of this role is flexible and can be based anywhere in the – Amazon Store

Remote, USA Full-time

**Customer Experience Specialist – Commercial Sector, blithequark Business**

Remote, USA Full-time

Remote Vacation Booker- Part Time

Remote, USA Full-time

Experienced Remote Customer Service Representative – Delivering Exceptional Customer Experiences with blithequark

Remote, USA Full-time

[Remote] Senior Accountant (Worldwide Remote)

Remote, USA Full-time

Costco Data Entry (Remote, Part/Full Time) $65000/Year

Remote, USA Full-time

Health Consultant/Customer Experience Representative

Remote, USA Full-time

Experienced Remote CVS Data Entry Specialist – Entry Level Work from Home Opportunity with Competitive Salary and Comprehensive Benefits

Remote, USA Full-time

**Experienced Customer Service Representative – Remote Opportunity to Deliver Exceptional Blithequark Experiences**

Remote, USA Full-time

Experienced Remote Data Entry Clerk and Typing Specialist – Administrative Support for Healthcare Team at blithequark

Remote, USA Full-time
Back to Home