Supervisor, Quality Interventions/QI Compliance (Remote in AZ) - Molina Healthcare : Job Details

**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.

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Pay Range: $60,415 - $117,809 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.