• Facility Site Review Nurse (Remote in Los Angeles…

    Molina Healthcare (Los Angeles, CA)


    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.

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    Pay Range: $84,067 - $163,931 / ANNUAL

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