Specialist, Quality Interventions/QI Compliance- Remote
<div><strong>Job Description</strong><br><br><strong>JOB DESCRIPTION</strong><br><br><strong>Job Summary</strong><br><br>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.<br><br><strong>KNOWLEDGE/SKILLS/ABILITIES</strong><br><br>The Specialist, Quality Interventions/ QI Compliance contributes to one or more of these quality improvement functions: Quality Interventions and Quality Improvement Compliance.<br><ul> <li>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.</li> <li>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. </li> <li>Writes narrative reports to interpret regulatory specifications, explain programs and results of programs, and document findings and limitations of department interventions.</li> <li>Creates, manages, and/or compiles the required documentation to maintain critical quality improvement functions.</li> <li>Leads quality improvement activities, meetings, and discussions with and between other departments within the organization.</li> <li>Evaluates project/program activities and results to identify opportunities for improvement.</li> <li>Surfaces to Manager and Director any gaps in processes that may require remediation.</li> <li>Other tasks, duties, projects, and programs as assigned.</li></ul><br>This position may require same day out of office travel approximately 0 - 50% of the time, depending upon location.<br><br>This position may require multiple day out of town overnight travel approximately 0 - 20% of the time, depending upon location.<br><br><strong>JOB QUALIFICATIONS</strong><br><br><strong>Required Education</strong><br><br>Bachelor's Degree or equivalent combination of education and work experience.<br><br><strong>Required Experience</strong><br><ul> <li>Min. 3 years' experience in healthcare with 1 year experience in health plan quality improvement, managed care, or equivalent experience.</li> <li>Demonstrated solid business writing experience.</li> <li>Operational knowledge and experience with Excel and Visio (flow chart equivalent).</li></ul><br><strong>Preferred Education</strong><br><br>Preferred field: Clinical Quality, Public Health or Healthcare.<br><br><strong>Preferred Experience</strong><br><br>1 year of experience in Medicare and in Medicaid.<br><br><strong>Preferred License, Certification, Association</strong><br><ul> <li>Certified Professional in Health Quality (CPHQ)</li> <li>Nursing License (RN may be preferred for specific roles)</li> <li>Certified HEDIS Compliance Auditor (CHCA)</li></ul><br><br>To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.<br><br>Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.</div>
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