Back to all jobs

Specialist, Quality Interventions/QI Compliance- Remote

Work from home Full-time role Hiring

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. This position may require same day out of office travel approximately 0 - 50% of the time, depending upon location. This position may require multiple day out of town overnight travel approximately 0 - 20% of the time, depending upon location. 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) Nursing License (RN may be preferred for specific roles) 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: $20.73 - $42.55 / HOURLY • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Apply Job!

More remote roles to explore

Enterprise Resource Planning Application Systems Specialist's, IS Enterprise Services, Fully Remote

Work from home Full-time role

Join the Amazon Team: Work from Home with No Experience Required!

Work from home Full-time role

Expert Analytical Solutions is hiring: Remote Part Time Data Entry Work From Hom

Work from home Full-time role

Remote Database Clerk Entry

Work from home Full-time role

Wisconsin Partnership Program Student Hourly

Work from home Full-time role

Student - Reading Partners Literacy Tutor

Work from home Full-time role

Billing Account Analyst (Remote - Wisconsin Residents)

Work from home Full-time role

Customer Support Representative

Work from home Full-time role

Respiratory Therapist - $1,498 per week

Work from home Full-time role

Auto Technician - Entry Level

Work from home Full-time role

[Remote] Account Manager - Accredo

Work from home Full-time role

Immediately Need Substitute Teacher in Ridgefield Park, NJ

Work from home Full-time role

Experienced Customer Experience Manager – Union Benefits Sales Representative – Fully Remote Opportunity

Work from home Full-time role

Sales Manager DACH - AT & CH

Work from home Full-time role

Vice President HR - Rewards, Talent & Operations

Work from home Full-time role

Customer Experience Advisor (Part-Time) (Remote, based in Nashville)

Work from home Full-time role

Join Today: Want Restaurant Team Member - Crew (2943 - Closter)

Work from home Full-time role

Experienced Customer Service Manager – Bedding Product Expert – Remote Overnight Shift

Work from home Full-time role

AI Quality Assurance Engineer​/AI Tester; AI-Augmented Testing Focus

Work from home Full-time role

AI Solutions Engineer - Europe

Work from home Full-time role