Specialist, Quality Interventions / QI Compliance (Remote)

Remote 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 tot his job
Apply Now →

Similar Jobs

Museum Specialist

Remote Full-time

Provider Network Access Specialist - Remote

Remote Full-time

Netflix Customer Service Jobs – Part-Time

Remote Full-time

Hybrid Entry Level Claims Adjuster (Houston, TX, US)

Remote Full-time

Chat Support Remote Jobs Hiring Now – Apply Today, No Phone | $25–$35/hr

Remote Full-time

Medical Records Administrator job at Spire Healthcare Group in Washington, DC

Remote Full-time

Registered Nurse (RN) - Hybrid or Teletherapy

Remote Full-time

Account Executive (UT, NV, CO)

Remote Full-time

Temporary Part-time Data Entry Specialist

Remote Full-time

Part-Time Administrative Assistant – Marketing, HR & Content Support (Temporary, 3 Months)

Remote Full-time

DaBella – $2,000 PAID TRAINING- Sales Representative – Salt Lake City, UT

Remote Full-time

Experienced Part-Time Customer Service Representative – Remote Work Opportunity with blithequark for Career Growth and Flexibility

Remote Full-time

Product Manager/ AI /Remote from New Zealand/

Remote Full-time

Experienced Full Stack Android Software Engineer – Mobile App Development and Customer Experience Enhancement at arenaflex

Remote Full-time

Mechanical Infrastructure Engineer; Remote

Remote Full-time

Sr. SAP S/4HANA Functional Consultant (Funds Management) - U.S. Citizenship Required

Remote Full-time

Experienced Customer Service Representative – Remote Full-Time Opportunity with blithequark for Delivering Exceptional Customer Experiences

Remote Full-time

**Experienced Entry-Level Customer Relations Chat Agent – Remote Opportunity with arenaflex**

Remote Full-time

Experienced Remote Chat Agent and Customer Service Representative – Entry-Level Full-Time and Part-Time Opportunities with Comprehensive Training and Competitive Hourly Rates at arenaflex

Remote Full-time

Policy Counsel / Policy Advisor for Democracy Reform

Remote Full-time
← Back to Home