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Molina Healthcare Group
Louisville, KY | Full Time
$79k-102k (estimate)
1 Week Ago
Molina Healthcare
Louisville, KY | Full Time
$79k-102k (estimate)
1 Week Ago
Supervisor, Quality Interventions/QI Compliance- Remote in Kentucky
Molina Healthcare Louisville, KY
$79k-102k (estimate)
Full Time | Insurance 1 Week Ago
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Molina Healthcare is Hiring a Remote Supervisor, Quality Interventions/QI Compliance- Remote in Kentucky

Job DescriptionJob SummaryMolina'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/AbilitiesThe 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 QualificationsRequired 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 EducationAdvanced 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: $54,373.27 - $117,808.76 / ANNUAL
  • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Job Summary

JOB TYPE

Full Time

INDUSTRY

Insurance

SALARY

$79k-102k (estimate)

POST DATE

06/21/2024

EXPIRATION DATE

07/17/2024

WEBSITE

molinahealthcare.com

HEADQUARTERS

ALBUQUERQUE, NM

SIZE

7,500 - 15,000

FOUNDED

1980

TYPE

Public

CEO

MARIO MOLINA

REVENUE

$10B - $50B

INDUSTRY

Insurance

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About Molina Healthcare

Molina is a managed care organization providing health care to individuals and families in 13 states & Puerto Rico via Medicaid & Medicare programs.

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