- Molina Healthcare (Green Bay, WI)
- …NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Health Plan Quality Interventions is ... responsible for developing, implementing, and monitoring the success of quality improvement interventions . The Manager works to coordinate resources and… more
- Molina Healthcare (Green Bay, WI)
- …plan to achieve performance goals. + Direct management of QS HPP program manager . Coordination with health plan quality staff. Ensure organization with other ... years of experience in Managed Care and/or health plan quality . Clinical experience is needed for positions...for positions that are focused on Accreditation, Compliance, HEDIS Interventions , Potential Quality of Care issues, and… more
- Molina Healthcare (Green Bay, WI)
- …services. **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Active and unrestricted Certified Case Manager (CCM) Clinical Social Worker license in good standing ... HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of… more
- Molina Healthcare (Green Bay, WI)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers identified… more
- Molina Healthcare (Green Bay, WI)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. + Promotes integration… more
- Molina Healthcare (Green Bay, WI)
- …accuracy of abstracted records as required by specifications. + Assists the quality improvement staff with physician and member interventions and incentive ... **Job Description** **Job Summary** Molina's Quality Improvement Lead Overreader conducts oversight and audits...off of the audit and chart review. + Assists Manager and Supervisor(s) in leading the training and mentoring… more