We are seeking RN (Registered Nurse) Facility Site Review, who must live in the state of CALIFORNIA; LOS ANGELES COUNTY preferred. Excellent computer skills and attention to detail are very important. Virtual office skills are necessary to be collaborative between team members using MS Teams, videoconference, voice conferencing and email/ chat communications.
This position will require FREQUENT TRAVEL in the field to do facility visits in the LA County area, County as well. Mileage will be reimbursed. Valid driver’s license and proof of auto insurance is required.
Schedule: Monday thru Friday 8:00AM to 5:00PM / 1 hour lunch break.
SKILLS THAT ARE NICE TO HAVE: Health Plan/Managed Care experience, must be able to use Microsoft office, outlook, excel, teams. Helpful to have some sort of supervisor experience and strong interpersonal skills, in order to communicate deficiencies with providers. Must be able to address and uphold standards in conflict. Must be good at time management and operating on travel without day to day instruction
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
Pay Range: $66,456 – 129,590 annually
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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.