Facility Site Review Nurse (Remote)

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.