Specialist, Member & Community Interventions - Quality​/HEDIS; Remote in OH

Overview

Specialist, Member & Community Interventions (Remote in OH)

• Implements evidence-based and data-informed key member intervention strategies, which may include initiating and managing member and/or community interventions (e.g., removing barriers to care) and other federal and state-required quality activities
• Monitors and ensures that key member intervention 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 program milestones, deadlines, and/or deliverables
• Participates in quality improvement activities, meetings, and discussions with and between other departments within the organization
• Supports provision of high-quality clinical care and services by facilitating/building strategic relationships with community-based organizations
• Evaluates project/program activities and results to identify opportunities for improvement
• Surfaces to the Manager and Director any gaps in processes that may require remediation
• Demonstrates flexibility when it comes to changes and maintains a positive outlook
• Other tasks, duties, projects, and programs as assigned
• This position may require same-day out-of-office travel 0 - 80% of the time, depending upon location
• This position may require multiple days out-of-town overnight travel on occasion, depending upon location

Required Qualifications

• Associate’s degree or equivalent combination of education and work experience
• 1-3 years’ experience in healthcare with 1-year experience in health plan quality member interventions, managed care, or equivalent experience
• Demonstrated solid business writing experience
• Operational knowledge and experience with Excel and Visio (flow chart equivalent)
• Excellent problem-solving skills

Preferred Qualifications

• Bachelor’s Degree in preferred field:
  Nursing, Social Work, Clinical Quality, Public Health, or Healthcare Administration
• 1 year of experience in Medicare and in Medicaid managed care
• 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: $49,930 - $97,363 / ANNUAL

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