Be an early applicantLess than 25 applicantsPosted by Agency

Company

Molina Healthcare · 1 day ago

Specialist, Quality Management (Remote in Arizona)

Arizona, United States

Full-time

Remote

Mid Level

$45K/yr - $97K/yr

3+ years exp

Maximize your interview chances

Health CareHospital

H1B Sponsor Likely

Insider Connection @Molina Healthcare

Discover valuable connections within the company who might provide insights and potential referrals.
Get 3x more responses when you reach out via email instead of LinkedIn.

Responsibilities

Facilitates individual and systemic quality of care investigations.

Monitors and evaluates the structure and processes for tracking and trending reportable incidents, quality of care events, member service concerns, and mortalities.

Organizes and manages quality monitoring activities, including audits of medical record quality, services and service sites, health and safety, and follow-up of monitoring of placement settings.

Creates, manages, and leads quality management activities, meetings, and discussions with and between other departments within the organization.

Evaluates project/program activities and results to identify opportunities for improvement.

Monitors and collaborates with Manager and Director to address any gaps in processes that may require remediation.

Creates and implements written documentation and business practices (e.g., policies and procedures, desk-level procedures, manuals, and process flows) that explain the business requirements and how the unit operationalizes those requirements.

Maintains the creation and ongoing revision of policies and procedures reflective of state requirements for all quality management functions, including quality monitoring audits, credentialing and recredentialing, quality of care concerns, and peer review.

Is well-versed in the requirements of the quality management program and day-to-day work processes to support compliance with state contract, policies, and program requirements.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Healthcare experienceQuality improvementHEDISBusiness writingMicrosoft OfficeProject coordinationCPHQ certificationNursing License

Required

Bachelor's Degree or equivalent combination of education and work experience.

Min. 3 years experience in healthcare with 1 year experience in health plan quality improvement, managed care or equivalent experience.

Demonstrated experience with Quality, HEDIS, RA or equivalent.

Demonstrated solid business writing experience.

Proficient in Microsoft Office tools (Outlook, Excel, Visio, etc.)

Preferred

Preferred field: Clinical Quality, Public Health, or Healthcare.

2 years project coordination experience.

Ability to work across all levels of the organization, including working with executive audiences, vendors, providers, and the government as a customer.

Certified Professional in Health Quality (CPHQ)

Nursing License (RN may be preferred for specific roles)

Company

Molina Healthcare

Glassdoor

3.4

Molina Healthcare is a healthcare company that specializes in government-sponsored healthcare programs for families and individuals.

Founded in 1980

Long Beach, California, USA

10001+ employees

https://careers.molinahealthcare.com

H1B Sponsorship

Molina Healthcare has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2023 (33)

2022 (36)

2021 (33)

2020 (60)