Specialist, Quality Interventions/QI Compliance

2 weeks ago

Milwaukee, United States Molina Healthcare Full time

**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.

Although remote, _you must reside in_ **_Wisconsin_** _for this position._

**KNOWLEDGE/SKILLS/ABILITIES**

The Specialist, Quality Interventions/ QI Compliance contributes to one or more of these quality improvement functions: Quality Interventions and Quality Improvement Compliance.

+ Implements key quality strategies, which may include initiation and management of provider, member and/or community interventions (e.g., removing barriers to care); preparation for Quality Improvement Compliance surveys; and other federal and state required quality activities.

+ Monitors and ensures that key quality 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 quality improvement functions.

+ Leads quality improvement activities, meetings, and discussions with and between other departments within the organization.

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

+ Surfaces to Manager and Director any gaps in processes that may require remediation.

+ Other tasks, duties, projects, and programs as assigned.

This position may require same day out of office travel approximately 0 - 50% of the time, depending upon location.

This position may require multiple day out of town overnight travel approximately 0 - 20% of the time, depending upon location.

**JOB QUALIFICATIONS**

**Required Education**

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

**Required Experience**

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

+ Demonstrated solid business writing experience.

+ Operational knowledge and experience with Excel and Visio (flow chart equivalent).

**Preferred Education**

Preferred field: Clinical Quality, Public Health or Healthcare.

**Preferred Experience**

1 year of experience in Medicare and in Medicaid.

**Preferred License, Certification, Association**

+ 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.

\#PJQA

\#LI-AC1

Pay Range: $19.64 - $42.55 / HOURLY

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

  • Specialist, Quality Interventions/qi Compliance

    1 month ago

    Milwaukee, United States Molina Healthcare Full time

    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...

  • Specialist, Quality Interventions/QI Compliance

    2 weeks ago

    Milwaukee, WI, United States Molina Healthcare Full time

    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...

  • Senior Professional Quality Compliance

    5 days ago

    Milwaukee, United States Versiti Inc. Full time

    Senior Professional Quality Compliance Job Locations US-WI-Milwaukee | US-MI-Grand Rapids ID 2024-9995 Category Legal and Compliance Position Type Full Time Overview Versiti is a fusion of donors, scientific curiosity, and precision medicine that recognize the gifts of blood and life are...

  • Senior Professional Quality Compliance

    1 week ago

    Milwaukee, Wisconsin, United States Versiti, Inc. Full time

    Overview: Versiti is a fusion of donors, scientific curiosity, and precision medicine that recognize the gifts of blood and life are precious. We are home to the world-renowned Blood Research Institute, we enable life saving gifts from our donors, and provide the science behind the medicine through our diagnostic laboratories. Versiti brings together...

  • Compliance Specialist

    1 week ago

    Milwaukee, United States Artisan Partners Full time

    The Compliance Specialist will be involved in various aspects of an ever-changing regulatory landscape within the Compliance Team of a global asset management firm. This individual will be primarily responsible for working closely with our marketing and distribution groups to ensure compliance in our marketing and distribution efforts and producing...

  • Compliance Specialist

    1 week ago

    Milwaukee, United States Artisan Partners Full time

    The Compliance Specialist will be responsible for administering the Code of Ethics and monitoring personal securities activity of Artisan Partners' associates and performing compliance testing and surveillance functions. The ideal candidate will have general compliance knowledge, strong analytical, interpersonal and organizational skills to drive...

  • Compliance Specialist

    1 month ago

    Milwaukee, United States Wellpoint Care Network Full time

    Job DescriptionJob DescriptionAt Wellpoint Care Network, our mission is to facilitate equity, learning, healing, and wellness by restoring the connections that help children and families thrive.Many of the people in our communities experience a sustained lack of fairness and opportunity fueled by inequitable systems, laws and policies that create significant...

  • Quality Specialist/Analyst

    1 week ago

    Milwaukee, Wisconsin, United States STS Technical Services Full time

    STS Technical Services is actively seeking candidates for a Quality Specialist/Analyst role with our Fortune 350 Client This job includes overall product quality responsibility through the life cycle of several product types. This includes overall quality responsibility for our supplier base, test, manufacturing, sales floor, control test, exercising,...

  • Quality Specialist/Analyst

    6 days ago

    Milwaukee, United States STS Technical Services Full time

    STS Technical Services is actively seeking candidates for a Quality Specialist/Analyst role with our Fortune 350 Client!  This job includes overall product quality responsibility through the life cycle of several product types.  This includes overall quality responsibility for our supplier base, test, manufacturing, sales floor, control test,...

  • Full Time Cardiology

    1 month ago

    Milwaukee, United States VISTA Staffing Solutions, Inc. Full time

    Well-established cardiology service seeks an additional BE/BC Interventional Cardiologist for its clinics outside of downtown Milwaukee, Wisconsin. - Join a team with two Interventional Cardiologists - Employed full-time position - Position includes one designated procedure day with option to add procedures during hospital rotation - Two clinic...

  • Quality Assurance Specialist

    4 weeks ago

    Milwaukee, United States Wisconsin Community Services Full time

    Position Summary : This position assists and supports the Bakari Center Program Manager to plan, design, monitor, and implement systemic practices and continuous improvement activities that enhance the effectiveness of program operations. The overall purpose is to create accountability with a focus on monitoring compliance and quality assurance and enhance...

  • Audit Compliance Analyst

    7 hours ago

    Milwaukee, United States LA CAUSA CHARTER SCHOOL Full time

    JOB REQUIREMENTS: Description JOB TITLE: Audit & Compliance Analyst FLSA STATUS: Hourly / Overtime Eligible LOCATON: Administration / On-Site PRIMARY FUNCTION: Audits, reviews, and inspects, various records, files, contracts, and other agency documents to ensure compliance with both in house and outside requirements related to procedures, contract...

  • Quality Assurance Professional

    3 weeks ago

    Milwaukee, Wisconsin, United States Versiti, Inc. Full time

    Overview: Versiti is a fusion of donors, scientific curiosity, and precision medicine that recognize the gifts of blood and life are precious. We are home to the world-renowned Blood Research Institute, we enable life saving gifts from our donors, and provide the science behind the medicine through our diagnostic laboratories. Versiti brings together...

  • Audit & Compliance Analyst

    2 days ago

    Milwaukee, United States La Causa Full time

    Job Type Full-time Description JOB TITLE: Audit & Compliance Analyst FLSA STATUS: Hourly / Overtime Eligible LOCATON: Administration / On-Site PRIMARY FUNCTION: Audits, reviews, and inspects, various records, files, contracts, and other agency documents to ensure compliance with both in house and outside requirements related to procedures, contract...

  • Erosion Control Specialist

    4 weeks ago

    Milwaukee, United States Kapur & Associates Full time

    **Company Overview**: Kapur & Associates is a leading full-service consulting engineering firm headquartered in Wisconsin, recognized as one of the Top Places to Work for the past 13 years. We are currently seeking a motivated and skilled Erosion Control Specialist to join our team and play a vital role in preserving our environment while delivering...

  • Youth Service Specialist

    1 week ago

    Milwaukee, United States Boys II Men Transitional Living Home Full time

    '''Overview''' We are seeking a dedicated and compassionate Youth Specialist to join our team. As a Youth Specialist, you will play a vital role in providing support and guidance to young individuals in need. This is an opportunity to make a positive impact on the lives of youth and help them navigate through challenging situations. If you have a passion for...

  • Compliance Analyst

    3 days ago

    Milwaukee, United States Versiti, Inc. Full time

    Overview: Versiti is a fusion of donors, scientific curiosity, and precision medicine that recognize the gifts of blood and life are precious. We are home to the world-renowned Blood Research Institute, we enable life saving gifts from our donors, and provide the science behind the medicine through our diagnostic laboratories. Versiti brings together...

  • Quality Assurance Specialist

    4 days ago

    Milwaukee, WI, United States Wisconsin Community Services Full time

    Job Responsibilities:Position Summary: This position assists and supports the Bakari Center Program Manager to plan, design, monitor, and implement systemic practices and continuous improvement activities that enhance the effectiveness of program operations. The overall purpose is to create accountability with a focus on monitoring compliance and quality...

  • Quality Assurance Specialist

    12 hours ago

    Milwaukee, WI, United States Wisconsin Community Services Full time

    Job Responsibilities:Position Summary: This position assists and supports the Bakari Center Program Manager to plan, design, monitor, and implement systemic practices and continuous improvement activities that enhance the effectiveness of program operations. The overall purpose is to create accountability with a focus on monitoring compliance and quality...

  • Quality Assurance Manager

    5 days ago

    Milwaukee, United States Astrix Inc Full time

    Our client is a fast-growing and diverse, food and feed probiotic supplement manufacturer with a commitment to quality products is seeking a Quality Manager to join their growing team! Below covers everything you need to know about what this opportunity entails, as well as what is expected from applicants. Pay: $60k-70k Job Description: The Quality...