Specialist, Member & Community Interventions - Quality / HEDIS (Remote in OH)

Overview Specialist, Member & Community Interventions (Remote in OH) Responsibilities 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 Qualifications 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) Additional Information 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. #J-18808-Ljbffr