Quality Compliance Specialists

Company DescriptionJobs for Humanity is collaborating with Upwardly Global and with Unclassified to build an inclusive and just employment ecosystem. We support individuals coming from all walks of life. Company Name: UnclassifiedJob DescriptionJob Listing ID: 4102623 Job Title: Specialist, Quality InterventionsQI Compliance (Remote) Application Deadline: Open Until Filled Job Location: Salem Date Posted: 08312024 Hours Worked Per Week: Not Provided Shift: Not Provided Duration of Job: Either Full or Part Time, more than 6 months You may contact this employer directly.(Obtain the contact information to print or add to your jobs.)Job Summary: 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 federalstate QI compliance activities. Only candidates with previous experience in health care qualityHEDIS, report writing and leadership presentation. KNOWLEDGESKILLSABILITIES The Specialist, Quality Interventions QI Compliance contributes to one or more of these quality improvement functions: Quality Interventions and Quality Improvement Compliance. Health Plan experience across lines of business (MedicaidMarketplace). Implements key quality strategies, which may include initiation and management of provider, member andor 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, andor 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 projectprogram 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 MedicaidMarketplace. 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) MFDV. Pay Range: $21.82 - $42.55 HOURLY •Actual compensation may vary from posting based on geographic location, work experience, education andor skill level. Job Classification: Business Operations Specialists, All Other Access our statewide or regional occupation report for more information about wages, employment outlooks, skills, training programs, related occupations, and more. Compensation Salary: Not Provided Job Requirements Experience Required: See Job Summary Education Required: None Minimum Age: NA Gender: NA

Created: 2025-02-26