Molina Healthcare
Senior Specialist, Quality Prog Mgmt & Performance (RN) - Remote in AZ
This job is now closed
Job Description
- Req#: 2036353
Employer Industry: Healthcare Quality Management
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Competitive benefits and compensation package offered
- Work collaboratively in a dynamic and highly matrixed environment
- Chance to contribute to quality management programs and initiatives that improve member care
- Engaging role that allows for critical thinking and problem-solving to enhance healthcare delivery
What to Expect (Job Responsibilities):
- Conduct timely and accurate investigations into individual and systemic quality of care issues in accordance with state requirements
- Track and trend reportable incidents, quality of care events, and member service concerns
- Perform audits of medical records, services, and service sites to ensure quality monitoring
- Ensure completion of key quality activities involving clinical decision-making and present results to leadership
- Support the creation and revision of policies and procedures for quality management functions
What is Required (Qualifications):
- At least 3 years of experience in healthcare, with a minimum of 1 year in quality management and clinical quality investigations
- Active and unrestricted Registered Nurse license in the state of practice
- Knowledge of Healthcare Effectiveness Data Information Set (HEDIS) and National Committee for Quality Assurance (NCQA)
- Strong attention to detail, critical-thinking, and problem-solving skills
- Excellent verbal and written communication skills
How to Stand Out (Preferred Qualifications):
- Certified Professional in Health Quality (CPHQ)
- Experience with medical record abstraction
- Previous managed care experience
- Ability to work across all levels of the organization, including with executive audiences and government entities
#HealthcareQuality #QualityManagement #ClinicalSupport #CareerGrowth #ManagedCare
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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
Molina Healthcare is a managed care company headquartered in Long Beach, California, United States.
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