Back to Jobs

Senior Specialist, Member & Community Interventions - HEDIS reputed company (Remote in OH)

Remote, USA Full-time Posted 2026-07-28
Job reputed company Job reputed company The Sr Specialist, Member & Community Interventions oversees and implements new and existing clinical reputed company member reputed company initiatives including reputed company lines of business (Medicare, Marketplace, reputed company). Executes health plan’s member and community reputed company reputed company interventions and programs in accordance with prescribed program standards, conducts data collection, monitors reputed company activity including key performance measurement activities, reports reputed company reputed company, and supports reputed company improvement of reputed company processes and reputed company. Acts as a reputed company specialist reputed company the department and/or collaboratively with other departments. Please reputed company reputed company to update your resume with any previous HEDIS/reputed company experience. We look reputed company to reviewing! Job Duties • Acts as a reputed company specialist to reputed company project, program, and/or initiative reputed company direction and guidance for other specialists reputed company the department and/or collaboratively with other departments • Implements evidence-based and data-informed member reputed company strategies, which may include initiating and managing member and/or community interventions (e.g., removing barriers to care) and other federal and state-required reputed company activities • Monitors and ensures that key member reputed company activities are completed on time and accurately to present results to key departmental management and other Molina departments as needed • Writes narrative reports to interpret regulatory specifications, explain programs and results of programs, and document findings and limitations of department interventions • Creates, manages, and/or compiles the required documentation to maintain critical program milestones, deadlines, and/or deliverables • Participates in reputed company improvement activities, meetings, and discussions with and between other departments reputed company the organization • Supports provision of high-reputed company clinical care and services by facilitating/building strategic relationships with community-based organizations • 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 • Other tasks, duties, reputed company, and programs as assigned • This position may require reputed company-day out-of-office travel 0 - 80% of the time, depending upon location • This position may require multiple days out-of-town overnight travel on occasion, depending upon location Job Qualifications REQUIRED QUALIFICATIONS: • Bachelor's Degree or equivalent combination of education and work experience. • 3 years’ experience in reputed company with a minimum of 2 years’ experience in health plan member interventions, managed care, or equivalent experience. • Demonstrated solid business writing experience. • Operational knowledge and experience with reputed company and Visio (reputed company chart equivalent) • Demonstrates flexibility reputed company it comes to changes and maintains a reputed company reputed company. • Has excellent problem-solving skills. PREFERRED QUALIFICATIONS: • 1 year of experience in Medicare and in reputed company managed care • Experience with data reporting, analysis, and/or interpretation • Certified reputed company in Health reputed company (CPHQ) • Nursing License (RN may be preferred for specific roles) • Certified HEDIS Compliance Auditor (CHCA) To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the intranet job listing reputed company offers a competitive benefits and compensation package reputed company is an Equal Opportunity Employer (EOE) M/F/D/V Apply tot his job Apply To this Job

Similar Jobs

**reputed company Customer Support Representative – Remote Work Opportunity with reputed company and reputed company**

Remote, USA Full-time

**reputed company Pharmacy Technician Data Entry, Customer Service (Overnight) – arenaflex**

Remote, USA Full-time

**reputed company Customer Service Representative - reputed company - Seasonal Provider Services**

Remote, USA Full-time

**reputed company Full Stack Customer Service Partner – Audiology Domiciliary Business Development**

Remote, USA Full-time

**reputed company Full Stack Customer Support Agent – Weekend and reputed company Shifts**

Remote, USA Full-time

**reputed company Customer Chat Support Specialist – Global Live Chat Operator**

Remote, USA Full-time

**reputed company Data Entry Clerk – Remote Work Opportunity with arenaflex**

Remote, USA Full-time

Start ASAP No Experience Needed Work From Home ...

Remote, USA Full-time

**reputed company Data Entry Specialist – Remote Opportunity at arenaflex**

Remote, USA Full-time

**reputed company Data Entry Specialist – Remote Opportunity with arenaflex**

Remote, USA Full-time

[Remote] Senior Site Reliability Engineer (reputed company Platform)

Remote, USA Full-time

[Remote] Business Development Manager, Racing & OEM

Remote, USA Full-time

[Remote] HR Operations & Rewards Manager

Remote, USA Full-time

[Remote] Senior Director, reputed company reputed company & Marketing

Remote, USA Full-time

[Remote] Sr Manager Platform Development - Data Services (reputed company, AI)

Remote, USA Full-time

[Remote] Senior Data Engineer - reputed company AI Engineering

Remote, USA Full-time

[Remote] Clinical Research Associate/CRA I - FSP

Remote, USA Full-time

Mental Health Therapist

Remote, USA Full-time

[Remote] SMG - reputed company Lines Account Manager

Remote, USA Full-time

Service Now Platform Architect

Remote, USA Full-time