Talent.com
Specialist, Quality Interventions/QI Compliance (Remote)
Specialist, Quality Interventions/QI Compliance (Remote)Idaho Staffing • Nampa, ID, US
No longer accepting applications
Specialist, Quality Interventions / QI Compliance (Remote)

Specialist, Quality Interventions / QI Compliance (Remote)

Idaho Staffing • Nampa, ID, US
19 days ago
Job type
  • Full-time
  • Remote
Job description

Quality Interventions Specialist

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.

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.

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 : $21.82 - $42.55 / HOURLY

  • Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.
  • Create a job alert for this search

    Compliance Specialist • Nampa, ID, US

    Related jobs
    Remote Content QA Reviewer

    Remote Content QA Reviewer

    Outlier • Nampa, ID, United States
    Remote
    Full-time
    Earn up to $15 / hour + performance bonuses.Outlier, a platform owned and operated by Scale AI, is looking for.If you're passionate about improving models and excited by the future of AI, this is you...Show more
    Last updated: 7 hours ago • Promoted • New!
    Air Interdiction Agent

    Air Interdiction Agent

    U.S. Customs and Border Protection • Melba, Idaho, US
    Full-time +1
    Pilot CBP Air Interdiction Agent.Considering making an application for this job Check all the details in this job description, and then click on Apply. Air and Marine Operations (AMO), a component o...Show more
    Last updated: 30+ days ago • Promoted
    Transportation Revenue System Specialist

    Transportation Revenue System Specialist

    CDM Smith • Nampa, ID, United States
    Full-time
    Works with and leads multi-disciplinary teams to help our customers design, test, implement, and oversee solutions for transportation revenue collection. The position will focus on design, procureme...Show more
    Last updated: 18 days ago • Promoted
    Director of Quality

    Director of Quality

    Johnson Thermal Systems • Caldwell, ID, US
    Full-time
    The Director of Quality is responsible for developing and leading the company's overall quality strategy to ensure all products meet or exceed customer expectations, regulatory standards, and inter...Show more
    Last updated: 30+ days ago • Promoted
    Activity Therapist - PRN

    Activity Therapist - PRN

    Haven Behavioral Healthcare • Letha, ID, USA
    Full-time
    Hours : PRN- Daytime hours (some weekend hours required as well).Cottonwood Creek Behavioral Hospital provides high-quality, specialty behavioral health services for individuals with mental health a...Show more
    Last updated: 30+ days ago • Promoted
    Risk & Quality Performance Manager

    Risk & Quality Performance Manager

    Idaho Staffing • Nampa, ID, US
    Full-time
    Risk & Quality Performance Manager.The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position collaborates with various departments and ...Show more
    Last updated: 30+ days ago • Promoted
    Cardiology Interventional

    Cardiology Interventional

    RecruitWell • Nampa, Idaho, US
    Full-time
    Cardiology Interventional physician job in Idaho : .Locum Interventional Cardiologist Nampa, Idaho.Call Coverage Only | IMLC Welcome | Multiple 20252026 Dates). Coverage Type : Call Only (No Clinic)....Show more
    Last updated: 30+ days ago • Promoted
    CNA Nurse Aide (Melba, ID)

    CNA Nurse Aide (Melba, ID)

    Visiting Angels • Melba, ID, United States
    Full-time +1
    No resume needed to apply! Complete our easy online application, or call 208-888-3611 to speak to a hiring manager today. All shifts available - FT / PT - Days / Weekends.Cash Referral Bonuses for Careg...Show more
    Last updated: 11 days ago • Promoted
    Clinical Growth Manager Caldwell, ID

    Clinical Growth Manager Caldwell, ID

    Fay • Caldwell, ID, US
    Full-time
    Clinical Growth Manager Caldwell, ID.Fay is a 3-sided AI platform redefining preventative care with a b2b2c business in a box. We're one of the fastest growing companies in tech and the fastest gro...Show more
    Last updated: 30+ days ago • Promoted
    Remote Text Quality Evaluator

    Remote Text Quality Evaluator

    Outlier • Nampa, ID, United States
    Remote
    Full-time
    Earn up to $15 / hour + performance bonuses.Outlier, a platform owned and operated by Scale AI, is looking for.If you're passionate about improving models and excited by the future of AI, this is you...Show more
    Last updated: 7 hours ago • Promoted • New!
    Specialist, Claims Recovery (Remote)

    Specialist, Claims Recovery (Remote)

    Remote Staffing • Nampa, ID, US
    Remote
    Full-time
    Provides support for claims recovery activities including researching claim payment and billing guidelines, audit results, and federal regulations to determine overpayment accuracy and provider com...Show more
    Last updated: 23 days ago • Promoted
    Youth Crisis Center Peer Support Specialist - PRN

    Youth Crisis Center Peer Support Specialist - PRN

    Clarvida • Murphy, ID, US
    Full-time
    Clarvida’s success is built on the strength of our people : individuals who bring the right skills and a deep commitment to our mission of improving lives and communities. Our employees are empowered...Show more
    Last updated: 30+ days ago
    Behavior Technician

    Behavior Technician

    Opal Autism Centers • Nampa, ID, US
    Full-time
    Quick Apply
    Behavior Technician (RBT in Training).Bridgeway Place, Suite 150, Eagle, Idaho 83616 .Applied Behavior Analysis (ABA).Registered Behavior Technician in Trai...Show more
    Last updated: 8 days ago
    Work From Home

    Work From Home

    Remote Jobs • Murphy, ID, United States
    Remote
    Full-time
    Remote Jobs are now available in your area.This position is a work from home position.You will not need to come into the office. Benefits : Health Insurance, 401K, Vacation& PTO.Apply now! Work from ...Show more
    Last updated: 15 days ago • Promoted
    Transition Specialist

    Transition Specialist

    Management and Training Corporation • Nampa, ID, United States
    Full-time
    Full Time, 8hr shifts, Monday - Friday.Our staff also enjoy these benefits : .Medical, dental, vision, prescription drug and life insurance. Paid time off and paid holidays.Professional development as...Show more
    Last updated: 11 days ago • Promoted
    Lead Analyst, Quality Analytics and Performance Improvement (HEDIS)

    Lead Analyst, Quality Analytics and Performance Improvement (HEDIS)

    Molina Healthcare • Caldwell, ID, United States
    Full-time
    The Lead Analyst, Quality Analytics and Performance Improvement role will support Molina's Quality Reporting team.Designs and develops reporting solutions to assist HEDIS Outbound, Inbound extracts...Show more
    Last updated: 26 days ago • Promoted
    Work from Home / Online Opportunity - Part-time with Flexible Scheduling & No Experience Necessary!

    Work from Home / Online Opportunity - Part-time with Flexible Scheduling & No Experience Necessary!

    HomeJobFinder • New Plymouth, ID
    Remote
    Part-time
    Remote Opportunity : Link Posting Marketing Rep (No Experience Needed!) Are you self-driven, reliable, and ready to earn from anywhere? We’re looking for motivated individuals to jo...Show more
    Last updated: 4 days ago • Promoted
    County Meter Reader

    County Meter Reader

    Meter Reader • New Plymouth, ID
    Full-time
    Responsibilities The primary responsibility of this position is to read meters and record consumption of the water used, cleaning of meter boxes, and removal of vegetation impeding access to meters...Show more
    Last updated: 25 days ago • Promoted