Supervisor, Quality Interventions/QI Compliance (...

**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 Supervisor, Quality Interventions/Compliance supervises staff who contribute to one or more of these quality improvement functions: Quality Interventions and / or QI Compliance. + Supervises other staff who have the responsibility for the implementation of key quality improvement (QI) 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. + Implements Molina Healthcare goals and oversees local processes for quality interventions, accreditation, State compliance activities, CMS quality activities and/or other QI interventions or compliance duties as required. + Defines and documents QI Interventions and/or Compliance policies and procedures for the work team. + Identifies and reports gaps in processes that may result in gaps in member care or satisfaction. + Works to ensure that any differences in health plan QI processes from the standard Corporate model have sufficient justification based on market/business needs or State-specific regulations. + Provides and oversees reporting requirements to regulatory agencies. + Effectively manages internal and external vendor communications by collaborating and disseminating reports, defining program descriptions, and sharing analytical findings. + Implements, monitors, and evaluates QI interventions and/or compliance activities in consultation with the Manager, Director, and / or AVP of the department. + Works collaboratively with other Molina Health Plan and/or Corporate departments as needed to accomplish QI activities and to ensure that all tasks are accomplished timely and accurately. **JOB QUALIFICATIONS** **Required Education** + Bachelor's Degree or equivalent combination of education or experience. + Required Experience + Min. 4 years' experience in healthcare with minimum 2 years' 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** Advanced degree in Clinical Quality, Public Health or Healthcare. **Preferred Experience** + HEDIS reporting or collection + CAHPS improvement experience + State QI experience. + Provider credentialing; PQOC review + Medicaid experience. + Supervisory experience. + Project management and team building experience. + 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: $69,477 - $135,480 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Created: 2025-01-30