Description
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
Responsible for timely performance of Facility reviews and appropriate follow up for network practitioners in compliance with DHS requirements; NCQA Standards and Molina Policies and Procedures. Reports, letters, and all follow up information must be submitted in compliance with set standards for content and timing requirements.
- Collaborates with practitioners and their staff, conveys Molina’s commitment to assisting practitioners to comply with all federal, state, and local regulations and related accrediting agency standards.
- Maintains confidentiality of data, communications, and interactions, internally and externally.
- Updates and assistance in maintenance of Site Review Database, Report Preparation, and submission within set Molina Standards.
- Participates in internal reviews, including, but not limited to, inter-rater reliability activities, designed to maintain consistency of work process.
- Presents problems and recommended solutions to Quality Improvement management.
JOB QUALIFICATIONS
Required Education
Completion of an accredited Registered Nurse (RN) Program or Bachelor’s in Nursing.
Required Experience
Minimum 3 years clinical experience.
Required License, Certification, Association
Active, unrestricted State Registered Nursing (RN) license in good standing.
Preferred Education
Bachelor of Science Degree in Nursing
Preferred Experience
1+ year of experience in Managed Care
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: $84,067 – $163,931 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.