What are the responsibilities and job description for the Specialist, Quality Interventions/QI Compliance (Remote in KY) position at Passport Health Plan by Molina Healthcare?
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
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
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
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M / F / D / V.
Job Type : Full Time Posting Date : 01 / 09 / 2025
Salary : $21 - $43
