3 Results Driven Attitude jobs in Tucson
Enterprise Performance Management (EPM) - Senior - Tech Consulting - Location Open
85702 Tucson, Arizona
EY
Posted today
Job Viewed
Job Description
Location: Anywhere in Country
At EY, we're all in to shape your future with confidence.
We'll help you succeed in a globally connected powerhouse of diverse teams and take your career wherever you want it to go. Join EY and help to build a better working world.
Consulting - Tech Consulting - FinTech - Enterprise Performance Management (EPM) - Senior
Whole industries have been disrupted and transformed in recent years by changing technologies, advanced analytics and the need for better insight. EY is helping businesses realize the value they can gain from their IT investments. We deliver exceptional client service - providing advice on how technology, finance process efficiency and enterprise intelligence contribute to performance improvement, as well as how IT can act as a multiplying effect during major program transformations.
**The opportunity**
Our EPM team helps apply cutting-edge technology and techniques to bring solutions to our clients. You will help our clients navigate the complex world of Enterprise Performance Management through detailed process design and implementation support. Our Advisory Seniors specialize in serving EY clients by guiding them through complex systems of forecasting, planning, budgeting and the integration with analytical and reporting solutions.
We'll look to you to provide our clients with a unique business perspective on how these processes can transform and improve their entire organization - starting with key business issues they face. This is an expanding area of our practice with high growth and plenty of opportunities to enhance the skillsets of individuals looking to build a career.
As a Senior Solution Architect, you will be the linchpin in translating business requirements into technical realities. Your expertise will shape the architecture of solutions to align with business goals, making a significant impact on our project delivery. You'll find yourself evaluating solution architectures, coordinating junior colleagues, and interacting with clients daily, possibly leading client workstreams.
Your key responsibilities In this role, you will be at the forefront of bridging business and technology, with responsibilities including:
+ Translating business requirements into technical solutions
+ Assessing the impact of technical decisions on business outcomes
+ Contributing to project delivery and tracking status
+ Engaging with clients and leading workstreams as needed
+ Supporting sales activities and maintaining engagement economics
**Skills and attributes for success**
To thrive in this role, you will need a blend of technical proficiency and business acumen, including:
+ User feedback and reflection to develop self-awareness, personal strengths and address development areas.
+ Cultivating and managing business development opportunities. Developing and maintaining long- term client relationships and networks.
+ Demonstrate critical thinking and the ability to bring order to unstructured problems.
+ Review your deliverables and that of others for quality, accuracy, and relevance.
+ See and embrace opportunities which give exposure to different situations, environments, and perspectives.
+ Managing expectations of client service delivery.
+ Application and Tool Analysis
+ Cloud Computing Architecture
+ Data Architecture Design and Modeling
+ Solution Architecture Design
+ Relationship Management
+ Communication
+ Complex Problem-Solving
+ Critical Thinking
+ Emotional Agility
+ Hybrid Collaboration
**To qualify for the role, you must have**
+ A Bachelor's degree
+ 2-4 years of relevant experience
+ A minimum of three years' experience in providing consulting experience
+ Working knowledge of a component of the modern EPM solutions landscape (e.g. Anaplan, Oracle EPM, FCCS, PBCS, EPBCS, ARCS, OneStream, Tagetik)
+ Proven track record of understanding business challenges and translating them into value-add solutions - strong analytical and problem- solving skills - actively participate in brainstorming, identifying core issues and effectively finding and using data to manage complex analysis
+ Our candidates have a variety of backgrounds including:
+ Management reporting
+ Long Range planner
+ Strategic planner
+ Capital planner
+ Implementation consultant
+ Strong analytical and problem- solving skills as well as excellent oral and written communication skills
+ A willingness to travel to meet client needs; travel is estimated at 80%.
**Ideally, you'll also have**
+ Degree emphasis in Finance, Accounting, Economics, Business, Computer Science, MIS, or IT preferred
+ Strong ability to build and manage relationships
+ Effective communication skills
+ Trust-building capabilities with clients
**What we look for**
We are looking for top performers who excel in a dynamic environment, have a passion for technology and architecture, and are eager to drive innovation. Your ability to solve complex problems, think critically, and collaborate effectively will set you apart as a candidate.
**What we offer you**
At EY, we'll develop you with future-focused skills and equip you with world-class experiences. We'll empower you in a flexible environment, and fuel you and your extraordinary talents in a diverse and inclusive culture of globally connected teams. Learn more .
+ We offer a comprehensive compensation and benefits package where you'll be rewarded based on your performance and recognized for the value you bring to the business. The base salary range for this job in all geographic locations in the US is $112,300 to $85,400. The base salary range for New York City Metro Area, Washington State and California (excluding Sacramento) is 134,700 to 210,700. Individual salaries within those ranges are determined through a wide variety of factors including but not limited to education, experience, knowledge, skills and geography. In addition, our Total Rewards package includes medical and dental coverage, pension and 401(k) plans, and a wide range of paid time off options.
+ Join us in our team-led and leader-enabled hybrid model. Our expectation is for most people in external, client serving roles to work together in person 40-60% of the time over the course of an engagement, project or year.
+ Under our flexible vacation policy, you'll decide how much vacation time you need based on your own personal circumstances. You'll also be granted time off for designated EY Paid Holidays, Winter/Summer breaks, Personal/Family Care, and other leaves of absence when needed to support your physical, financial, and emotional well-being.
**Are you ready to shape your future with confidence? Apply today.**
EY accepts applications for this position on an on-going basis.
For those living in California, please click here for additional information.
EY focuses on high-ethical standards and integrity among its employees and expects all candidates to demonstrate these qualities.
**EY | Building a better working world**
EY is building a better working world by creating new value for clients, people, society and the planet, while building trust in capital markets.
Enabled by data, AI and advanced technology, EY teams help clients shape the future with confidence and develop answers for the most pressing issues of today and tomorrow.
EY teams work across a full spectrum of services in assurance, consulting, tax, strategy and transactions. Fueled by sector insights, a globally connected, multi-disciplinary network and diverse ecosystem partners, EY teams can provide services in more than 150 countries and territories.
EY provides equal employment opportunities to applicants and employees without regard to race, color, religion, age, sex, sexual orientation, gender identity/expression, pregnancy, genetic information, national origin, protected veteran status, disability status, or any other legally protected basis, including arrest and conviction records, in accordance with applicable law?
EY is committed to providing reasonable accommodation to qualified individuals with disabilities including veterans with disabilities. If you have a disability and either need assistance applying online or need to request an accommodation during any part of the application process, please call 1-800-EY-HELP3, select Option 2 for candidate related inquiries, then select Option 1 for candidate queries and finally select Option 2 for candidates with an inquiry which will route you to EY's Talent Shared Services Team (TSS) or email the TSS at .
At EY, we're all in to shape your future with confidence.
We'll help you succeed in a globally connected powerhouse of diverse teams and take your career wherever you want it to go. Join EY and help to build a better working world.
Consulting - Tech Consulting - FinTech - Enterprise Performance Management (EPM) - Senior
Whole industries have been disrupted and transformed in recent years by changing technologies, advanced analytics and the need for better insight. EY is helping businesses realize the value they can gain from their IT investments. We deliver exceptional client service - providing advice on how technology, finance process efficiency and enterprise intelligence contribute to performance improvement, as well as how IT can act as a multiplying effect during major program transformations.
**The opportunity**
Our EPM team helps apply cutting-edge technology and techniques to bring solutions to our clients. You will help our clients navigate the complex world of Enterprise Performance Management through detailed process design and implementation support. Our Advisory Seniors specialize in serving EY clients by guiding them through complex systems of forecasting, planning, budgeting and the integration with analytical and reporting solutions.
We'll look to you to provide our clients with a unique business perspective on how these processes can transform and improve their entire organization - starting with key business issues they face. This is an expanding area of our practice with high growth and plenty of opportunities to enhance the skillsets of individuals looking to build a career.
As a Senior Solution Architect, you will be the linchpin in translating business requirements into technical realities. Your expertise will shape the architecture of solutions to align with business goals, making a significant impact on our project delivery. You'll find yourself evaluating solution architectures, coordinating junior colleagues, and interacting with clients daily, possibly leading client workstreams.
Your key responsibilities In this role, you will be at the forefront of bridging business and technology, with responsibilities including:
+ Translating business requirements into technical solutions
+ Assessing the impact of technical decisions on business outcomes
+ Contributing to project delivery and tracking status
+ Engaging with clients and leading workstreams as needed
+ Supporting sales activities and maintaining engagement economics
**Skills and attributes for success**
To thrive in this role, you will need a blend of technical proficiency and business acumen, including:
+ User feedback and reflection to develop self-awareness, personal strengths and address development areas.
+ Cultivating and managing business development opportunities. Developing and maintaining long- term client relationships and networks.
+ Demonstrate critical thinking and the ability to bring order to unstructured problems.
+ Review your deliverables and that of others for quality, accuracy, and relevance.
+ See and embrace opportunities which give exposure to different situations, environments, and perspectives.
+ Managing expectations of client service delivery.
+ Application and Tool Analysis
+ Cloud Computing Architecture
+ Data Architecture Design and Modeling
+ Solution Architecture Design
+ Relationship Management
+ Communication
+ Complex Problem-Solving
+ Critical Thinking
+ Emotional Agility
+ Hybrid Collaboration
**To qualify for the role, you must have**
+ A Bachelor's degree
+ 2-4 years of relevant experience
+ A minimum of three years' experience in providing consulting experience
+ Working knowledge of a component of the modern EPM solutions landscape (e.g. Anaplan, Oracle EPM, FCCS, PBCS, EPBCS, ARCS, OneStream, Tagetik)
+ Proven track record of understanding business challenges and translating them into value-add solutions - strong analytical and problem- solving skills - actively participate in brainstorming, identifying core issues and effectively finding and using data to manage complex analysis
+ Our candidates have a variety of backgrounds including:
+ Management reporting
+ Long Range planner
+ Strategic planner
+ Capital planner
+ Implementation consultant
+ Strong analytical and problem- solving skills as well as excellent oral and written communication skills
+ A willingness to travel to meet client needs; travel is estimated at 80%.
**Ideally, you'll also have**
+ Degree emphasis in Finance, Accounting, Economics, Business, Computer Science, MIS, or IT preferred
+ Strong ability to build and manage relationships
+ Effective communication skills
+ Trust-building capabilities with clients
**What we look for**
We are looking for top performers who excel in a dynamic environment, have a passion for technology and architecture, and are eager to drive innovation. Your ability to solve complex problems, think critically, and collaborate effectively will set you apart as a candidate.
**What we offer you**
At EY, we'll develop you with future-focused skills and equip you with world-class experiences. We'll empower you in a flexible environment, and fuel you and your extraordinary talents in a diverse and inclusive culture of globally connected teams. Learn more .
+ We offer a comprehensive compensation and benefits package where you'll be rewarded based on your performance and recognized for the value you bring to the business. The base salary range for this job in all geographic locations in the US is $112,300 to $85,400. The base salary range for New York City Metro Area, Washington State and California (excluding Sacramento) is 134,700 to 210,700. Individual salaries within those ranges are determined through a wide variety of factors including but not limited to education, experience, knowledge, skills and geography. In addition, our Total Rewards package includes medical and dental coverage, pension and 401(k) plans, and a wide range of paid time off options.
+ Join us in our team-led and leader-enabled hybrid model. Our expectation is for most people in external, client serving roles to work together in person 40-60% of the time over the course of an engagement, project or year.
+ Under our flexible vacation policy, you'll decide how much vacation time you need based on your own personal circumstances. You'll also be granted time off for designated EY Paid Holidays, Winter/Summer breaks, Personal/Family Care, and other leaves of absence when needed to support your physical, financial, and emotional well-being.
**Are you ready to shape your future with confidence? Apply today.**
EY accepts applications for this position on an on-going basis.
For those living in California, please click here for additional information.
EY focuses on high-ethical standards and integrity among its employees and expects all candidates to demonstrate these qualities.
**EY | Building a better working world**
EY is building a better working world by creating new value for clients, people, society and the planet, while building trust in capital markets.
Enabled by data, AI and advanced technology, EY teams help clients shape the future with confidence and develop answers for the most pressing issues of today and tomorrow.
EY teams work across a full spectrum of services in assurance, consulting, tax, strategy and transactions. Fueled by sector insights, a globally connected, multi-disciplinary network and diverse ecosystem partners, EY teams can provide services in more than 150 countries and territories.
EY provides equal employment opportunities to applicants and employees without regard to race, color, religion, age, sex, sexual orientation, gender identity/expression, pregnancy, genetic information, national origin, protected veteran status, disability status, or any other legally protected basis, including arrest and conviction records, in accordance with applicable law?
EY is committed to providing reasonable accommodation to qualified individuals with disabilities including veterans with disabilities. If you have a disability and either need assistance applying online or need to request an accommodation during any part of the application process, please call 1-800-EY-HELP3, select Option 2 for candidate related inquiries, then select Option 1 for candidate queries and finally select Option 2 for candidates with an inquiry which will route you to EY's Talent Shared Services Team (TSS) or email the TSS at .
View Now
0
Sr. Specialist, Quality Program Management & Performance RN

85702 Tucson, Arizona
Molina Healthcare
Posted today
Job Viewed
Job Description
**Job Description**
**JOB SUMMARY:**
The Senior Specialist, Quality Program Management & Performance RNensures quality monitoring audits and investigations are performed in accordance with prescribed quality standards. Informs data collection, reporting, and analysis to monitor key quality management activity and provides direction and implementation of federal/state quality management compliance activities. Supports the creation and ongoing revision of policies and procedures that reflect state requirements for all quality management functions. In accordance with state-based requirements, ensures quality of care investigations are performed timely and accurately.
**ESSENTIAL JOB DUTIES:**
+ Ensures individual and systemic quality of care investigations are performed timely, accurately, and in accordance with state-based requirements
+ Adheres to structure and processes for tracking and trending reportable incidents, quality of care events, member service concerns, and mortalities
+ Performs quality monitoring activities, including audits of medical record quality, services, and service sites, health and safety, and follow-up of monitoring of placement settings
+ Monitors and ensures that key quality activities that involve clinical decision-making are completed on time and accurately to present results to key departmental management and other Molina departments as needed
+ Implements key quality strategies that require a component of near real-time clinical decision-making. These activities may include preparation and review of potential quality of care and critical incident cases (as applicable)
+ Adheres to written documentation and business practices (e.g., policies and procedures, desk-level procedures, manuals, and process flows) that explain the business requirements and how the unit operationalizes those requirements
+ Supports the creation and ongoing revision of policies and procedures that reflect state requirements for all quality management functions, including quality monitoring audits, credentialing and re-credentialing, quality of care concerns, and peer review
+ Well-versed in the requirements of the quality program and day-to-day work processes to support compliance with state contracts, policies, and program requirements
+ 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. In particular, the Senior Specialist may be asked to focus on parts of the process where a clinician's perspective would be valuable to uncover process gaps or limitations
+ 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
+ This position may require same-day out-of-office travel approximately 0 - 50% of the time, depending on the location.
+ This position may require multiple day out of town overnight travel approximately 0 - 20% of the time, depending upon location.
**REQUIRED QUALIFICATIONS:**
+ Bachelor's Degree or equivalent combination of education and work experience.
+ Min. 3 years' experience in healthcare with a minimum of 1 year's experience in quality management and clinical quality investigations, or equivalent experience
+ Critical thinking skills
+ Strong communication skills, both verbally and written
+ Ability to interact effectively with health plan clinical leaders and peers across the organization
+ Proficient in Microsoft Office tools (Outlook, Excel, etc.) Communicates clearly and concisely and is able to tailor messaging to diverse audiences
+ Excellent problem-solving skills.
+ QM Nurse: Arizona-licensed RN or a Licensed Practical Nurse (LPN) with current Licensure under the Arizona State Board of Nursing (BON)
+ QM BH Nurse: Arizona-licensed registered nurse practitioner licensed as an adult, psychiatric and mental health nurse, or Arizona-licensed registered nurse with a psychiatric-mental health nursing certification, or one year of experience providing behavioral health services
**PREFERRED QUALIFICATIONS:**
+ Advanced degree in Nursing, Public Health, Health Administration, Social Work, or related field
+ 2 years of medical record abstraction experience
+ 1 year health plan quality management
+ Ability to work across all levels of the organization, including working with executive audiences, vendors, providers, and the government as a customer
+ Certified Professional in Health Quality (CPHQ)
**REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:**
+ QM Nurse: - Arizona-licensed RN or a Licensed Practical Nurse (LPN) with current Licensure under the Arizona State Board of Nursing (BON)
+ QM BH Nurse:- Arizona-licensed registered nurse practitioner licensed as an adult, psychiatric and mental health nurse, or- Arizona-licensed registered nurse with:a. A psychiatric-mental health nursing certification, or b. One year of experience providing behavioral health services.
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: $60,415 - $117,809 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
**JOB SUMMARY:**
The Senior Specialist, Quality Program Management & Performance RNensures quality monitoring audits and investigations are performed in accordance with prescribed quality standards. Informs data collection, reporting, and analysis to monitor key quality management activity and provides direction and implementation of federal/state quality management compliance activities. Supports the creation and ongoing revision of policies and procedures that reflect state requirements for all quality management functions. In accordance with state-based requirements, ensures quality of care investigations are performed timely and accurately.
**ESSENTIAL JOB DUTIES:**
+ Ensures individual and systemic quality of care investigations are performed timely, accurately, and in accordance with state-based requirements
+ Adheres to structure and processes for tracking and trending reportable incidents, quality of care events, member service concerns, and mortalities
+ Performs quality monitoring activities, including audits of medical record quality, services, and service sites, health and safety, and follow-up of monitoring of placement settings
+ Monitors and ensures that key quality activities that involve clinical decision-making are completed on time and accurately to present results to key departmental management and other Molina departments as needed
+ Implements key quality strategies that require a component of near real-time clinical decision-making. These activities may include preparation and review of potential quality of care and critical incident cases (as applicable)
+ Adheres to written documentation and business practices (e.g., policies and procedures, desk-level procedures, manuals, and process flows) that explain the business requirements and how the unit operationalizes those requirements
+ Supports the creation and ongoing revision of policies and procedures that reflect state requirements for all quality management functions, including quality monitoring audits, credentialing and re-credentialing, quality of care concerns, and peer review
+ Well-versed in the requirements of the quality program and day-to-day work processes to support compliance with state contracts, policies, and program requirements
+ 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. In particular, the Senior Specialist may be asked to focus on parts of the process where a clinician's perspective would be valuable to uncover process gaps or limitations
+ 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
+ This position may require same-day out-of-office travel approximately 0 - 50% of the time, depending on the location.
+ This position may require multiple day out of town overnight travel approximately 0 - 20% of the time, depending upon location.
**REQUIRED QUALIFICATIONS:**
+ Bachelor's Degree or equivalent combination of education and work experience.
+ Min. 3 years' experience in healthcare with a minimum of 1 year's experience in quality management and clinical quality investigations, or equivalent experience
+ Critical thinking skills
+ Strong communication skills, both verbally and written
+ Ability to interact effectively with health plan clinical leaders and peers across the organization
+ Proficient in Microsoft Office tools (Outlook, Excel, etc.) Communicates clearly and concisely and is able to tailor messaging to diverse audiences
+ Excellent problem-solving skills.
+ QM Nurse: Arizona-licensed RN or a Licensed Practical Nurse (LPN) with current Licensure under the Arizona State Board of Nursing (BON)
+ QM BH Nurse: Arizona-licensed registered nurse practitioner licensed as an adult, psychiatric and mental health nurse, or Arizona-licensed registered nurse with a psychiatric-mental health nursing certification, or one year of experience providing behavioral health services
**PREFERRED QUALIFICATIONS:**
+ Advanced degree in Nursing, Public Health, Health Administration, Social Work, or related field
+ 2 years of medical record abstraction experience
+ 1 year health plan quality management
+ Ability to work across all levels of the organization, including working with executive audiences, vendors, providers, and the government as a customer
+ Certified Professional in Health Quality (CPHQ)
**REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:**
+ QM Nurse: - Arizona-licensed RN or a Licensed Practical Nurse (LPN) with current Licensure under the Arizona State Board of Nursing (BON)
+ QM BH Nurse:- Arizona-licensed registered nurse practitioner licensed as an adult, psychiatric and mental health nurse, or- Arizona-licensed registered nurse with:a. A psychiatric-mental health nursing certification, or b. One year of experience providing behavioral health services.
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: $60,415 - $117,809 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
View Now
1
Sr. Specialist, Quality Program Management & Performance RN

85702 Tucson, Arizona
Molina Healthcare
Posted today
Job Viewed
Job Description
**Job Description**
**JOB SUMMARY:**
The Senior Specialist, Quality Program Management & Performance RNensures quality monitoring audits and investigations are performed in accordance with prescribed quality standards. Informs data collection, reporting, and analysis to monitor key quality management activity and provides direction and implementation of federal/state quality management compliance activities. Supports the creation and ongoing revision of policies and procedures that reflect state requirements for all quality management functions. In accordance with state-based requirements, ensures quality of care investigations are performed timely and accurately.
**ESSENTIAL JOB DUTIES:**
+ Ensures individual and systemic quality of care investigations are performed timely, accurately, and in accordance with state-based requirements
+ Adheres to structure and processes for tracking and trending reportable incidents, quality of care events, member service concerns, and mortalities
+ Performs quality monitoring activities, including audits of medical record quality, services, and service sites, health and safety, and follow-up of monitoring of placement settings
+ Monitors and ensures that key quality activities that involve clinical decision-making are completed on time and accurately to present results to key departmental management and other Molina departments as needed
+ Implements key quality strategies that require a component of near real-time clinical decision-making. These activities may include preparation and review of potential quality of care and critical incident cases (as applicable)
+ Adheres to written documentation and business practices (e.g., policies and procedures, desk-level procedures, manuals, and process flows) that explain the business requirements and how the unit operationalizes those requirements
+ Supports the creation and ongoing revision of policies and procedures that reflect state requirements for all quality management functions, including quality monitoring audits, credentialing and re-credentialing, quality of care concerns, and peer review
+ Well-versed in the requirements of the quality program and day-to-day work processes to support compliance with state contracts, policies, and program requirements
+ 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. In particular, the Senior Specialist may be asked to focus on parts of the process where a clinician's perspective would be valuable to uncover process gaps or limitations
+ 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
+ This position may require same-day out-of-office travel approximately 0 - 50% of the time, depending on the location.
+ This position may require multiple day out of town overnight travel approximately 0 - 20% of the time, depending upon location.
**REQUIRED QUALIFICATIONS:**
+ Bachelor's Degree or equivalent combination of education and work experience.
+ Min. 3 years' experience in healthcare with a minimum of 1 year's experience in quality management and clinical quality investigations, or equivalent experience
+ Critical thinking skills
+ Strong communication skills, both verbally and written
+ Ability to interact effectively with health plan clinical leaders and peers across the organization
+ Proficient in Microsoft Office tools (Outlook, Excel, etc.) Communicates clearly and concisely and is able to tailor messaging to diverse audiences
+ Excellent problem-solving skills.
+ QM Nurse: Arizona-licensed RN or a Licensed Practical Nurse (LPN) with current Licensure under the Arizona State Board of Nursing (BON)
+ QM BH Nurse: Arizona-licensed registered nurse practitioner licensed as an adult, psychiatric and mental health nurse, or Arizona-licensed registered nurse with a psychiatric-mental health nursing certification, or one year of experience providing behavioral health services
**PREFERRED QUALIFICATIONS:**
+ Advanced degree in Nursing, Public Health, Health Administration, Social Work, or related field
+ 2 years of medical record abstraction experience
+ 1 year health plan quality management
+ Ability to work across all levels of the organization, including working with executive audiences, vendors, providers, and the government as a customer
+ Certified Professional in Health Quality (CPHQ)
**QM Nurse:**
- Arizona-licensed RN or a Licensed Practical Nurse (LPN) with current Licensure under the Arizona State Board of Nursing (BON)
**QM BH Nurse:**
- Arizona-licensed registered nurse practitioner licensed as an adult, psychiatric and mental health nurse, or
- Arizona-licensed registered nurse with:
a. A psychiatric-mental health nursing certification, or
b. One year of experience providing behavioral health services
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: $60,415 - $117,809 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
**JOB SUMMARY:**
The Senior Specialist, Quality Program Management & Performance RNensures quality monitoring audits and investigations are performed in accordance with prescribed quality standards. Informs data collection, reporting, and analysis to monitor key quality management activity and provides direction and implementation of federal/state quality management compliance activities. Supports the creation and ongoing revision of policies and procedures that reflect state requirements for all quality management functions. In accordance with state-based requirements, ensures quality of care investigations are performed timely and accurately.
**ESSENTIAL JOB DUTIES:**
+ Ensures individual and systemic quality of care investigations are performed timely, accurately, and in accordance with state-based requirements
+ Adheres to structure and processes for tracking and trending reportable incidents, quality of care events, member service concerns, and mortalities
+ Performs quality monitoring activities, including audits of medical record quality, services, and service sites, health and safety, and follow-up of monitoring of placement settings
+ Monitors and ensures that key quality activities that involve clinical decision-making are completed on time and accurately to present results to key departmental management and other Molina departments as needed
+ Implements key quality strategies that require a component of near real-time clinical decision-making. These activities may include preparation and review of potential quality of care and critical incident cases (as applicable)
+ Adheres to written documentation and business practices (e.g., policies and procedures, desk-level procedures, manuals, and process flows) that explain the business requirements and how the unit operationalizes those requirements
+ Supports the creation and ongoing revision of policies and procedures that reflect state requirements for all quality management functions, including quality monitoring audits, credentialing and re-credentialing, quality of care concerns, and peer review
+ Well-versed in the requirements of the quality program and day-to-day work processes to support compliance with state contracts, policies, and program requirements
+ 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. In particular, the Senior Specialist may be asked to focus on parts of the process where a clinician's perspective would be valuable to uncover process gaps or limitations
+ 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
+ This position may require same-day out-of-office travel approximately 0 - 50% of the time, depending on the location.
+ This position may require multiple day out of town overnight travel approximately 0 - 20% of the time, depending upon location.
**REQUIRED QUALIFICATIONS:**
+ Bachelor's Degree or equivalent combination of education and work experience.
+ Min. 3 years' experience in healthcare with a minimum of 1 year's experience in quality management and clinical quality investigations, or equivalent experience
+ Critical thinking skills
+ Strong communication skills, both verbally and written
+ Ability to interact effectively with health plan clinical leaders and peers across the organization
+ Proficient in Microsoft Office tools (Outlook, Excel, etc.) Communicates clearly and concisely and is able to tailor messaging to diverse audiences
+ Excellent problem-solving skills.
+ QM Nurse: Arizona-licensed RN or a Licensed Practical Nurse (LPN) with current Licensure under the Arizona State Board of Nursing (BON)
+ QM BH Nurse: Arizona-licensed registered nurse practitioner licensed as an adult, psychiatric and mental health nurse, or Arizona-licensed registered nurse with a psychiatric-mental health nursing certification, or one year of experience providing behavioral health services
**PREFERRED QUALIFICATIONS:**
+ Advanced degree in Nursing, Public Health, Health Administration, Social Work, or related field
+ 2 years of medical record abstraction experience
+ 1 year health plan quality management
+ Ability to work across all levels of the organization, including working with executive audiences, vendors, providers, and the government as a customer
+ Certified Professional in Health Quality (CPHQ)
**QM Nurse:**
- Arizona-licensed RN or a Licensed Practical Nurse (LPN) with current Licensure under the Arizona State Board of Nursing (BON)
**QM BH Nurse:**
- Arizona-licensed registered nurse practitioner licensed as an adult, psychiatric and mental health nurse, or
- Arizona-licensed registered nurse with:
a. A psychiatric-mental health nursing certification, or
b. One year of experience providing behavioral health services
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: $60,415 - $117,809 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
View Now
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