Top 20 Quality and compliance auditor Jobs in Columbus

Sr Quality Improvement/HEDIS Spec, Health Plan Interventions (Remote In Ohio)
Molina Healthcare —Columbus, OH
- $54,922 - $107,099 a year
- Full-time
- Remote
- RN License
- Writing skills
- Analysis skills
- Health insurance
Senior Quality Assurance Specialist - Investigations
Andelyn Biosciences, Inc —Columbus, OH
- Full-time
- Microsoft Excel
- Bachelor's degree
- Continuous improvement
- Paid parental leave
- Paid holidays
Quick Apply
1d
Sr. Quality Assurance Engineer - Automation
Corporate One FCU —Columbus, OH
- $108,000 - $116,000 a year
- Azure
- Computer Science
- 5 years
- Wellness program
- Paid parental leave
Quick Apply
Commercial Lines Quality Assurance Senior Specialist (hybrid/remote)
Grange Insurance Company —Columbus, OH
- Remote
- 7 years
- Analysis skills
- Bachelor's degree
- Bereavement leave
9d
Senior Quality Assurance Engineer
Western Alliance Bank —Columbus, OH
- Full-time
- 7 years
- Office
- SQL
- Wellness program
- Health insurance
Senior IoT Quality Analyst - Cardio Partners - Dublin, OH
Sarnova —Dublin, OH
- Full-time
- Computer Science
- 5 years
- Analysis skills
- 401(k)
Quick Apply
Senior Director Quality Affairs
American Regent, Inc. —New Albany, OH
- Weekends as needed
- 11+ years
- Master's degree
- Bachelor's degree
Sr. Quality Engineer - Performance & Automation (Contract)
Blue Star Partners LLC —Columbus, OH
- $70 - $80 an hour
- Contract
- 3 years
- Analysis skills
- Continuous improvement
Quick Apply
Senior Director, Quality Assurance
kdc/one —Groveport, OH
- Full-time
- 5 years
- Laboratory experience
- Office
Quick Apply
Senior Field Quality Manager
Quanta Services —Columbus, OH
- OSHA
- 5 years
- Travel
- Paid parental leave
- Health savings account
Senior Product Quality Engineer
Anduril Industries —Columbus, OH
- $126,000 - $167,000 a year
- Email
- Oracle
- 5 years
- Engineering
Quick Apply
Senior Supplier Quality Engineer, Altius
Anduril Industries —Ashville, OH
- $126,000 - $167,000 a year
- Email
- Oracle
- Up to 50% travel
- Engineering
Quick Apply
14d
Senior Field Quality Manager
Quanta Infrastructure Solutions Group, LLC —Columbus, OH
- Full-time
- OSHA
- 5 years
- Travel
- Paid parental leave
- Health savings account
Senior Quality Assurance PM, Mechanical – Data Center Construction
Turner & Townsend —Ashville, OH
- Full-time
- Microsoft Outlook
- Construction site
- 5 years
Quick Apply
Senior Quality Coordinator
Holder Construction —Columbus, OH
- Full-time
- Background check
- Microsoft Outlook
- Construction site
- Health insurance
- Dental insurance
Quick Apply
Materials Testing Auditor - Independent Contractor
Performance Review Institute —United States
- Part-time
- 7 years
- Bachelor of Science
- Senior level
- Flexible schedule
- Referral program
Quick Apply

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Sr Quality Improvement/HEDIS Spec, Health Plan Interventions (Remote In Ohio)
Molina Healthcare —Columbus, OH
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$54,922 - $107,099 a year
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Sr Quality Improvement/HEDIS Spec, Health Plan Interventions (Remote In Ohio)

Molina Healthcare -
Columbus, OH

Apply Now

Job Details

Full-time
$54,922 - $107,099 a year

Benefits

Health insurance

Qualifications

Managed care
Managed care organization experience
Writing skills
Clinical program data analysis
Productivity software
Clinical data analysis

Full Job Description

Molina Healthcare of Ohio is hiring for a Sr Quality Improvement/HEDIS Specialist on our Health Plan Community Interventions team.
This role is remote however candidates must live in Ohio.

This role is laser focused on Quality Improvement using QI Science. This role will be assigned a primary population stream and will be expected to support improvement work for Medicare Stars Measures.

Highly qualified candidates will have the following experience-

Using the specific models for improvement required by the state of Ohio
Experience with a formal model like IHI or Lean or Six Sigma, Green or Yellow Belt Improvement
Power BI is helpful but expert level is not required
Familiarity with Medicare (Ideally the Duals population)
Familiarity with QI Science, Health Equity, Population Health, Health Management

This role also provides senior level support for clinical quality member intervention activities. Responsible for the developing and implementing new and existing member intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid, etc.). Executes health plan member and community quality-focused interventions and programs in accordance with established program standards, and federal/state/National Committee for Quality Assurance (NCQA) regulations. Conducts data collection, monitors intervention activity including key performance measurement activities, reports intervention outcomes, and supports continuous improvement of intervention processes and outcomes.

Essential Job Duties

Implements evidence-based and data-informed key member intervention strategies including initiating and managing member and/or community interventions (e.g., removing barriers to care) and other federal and state quality initiatives.
Monitors and ensures that key member intervention activities are completed on time and accurately, and presents results to key departmental management and other applicable Molina departments.
Writes narrative reports to interpret regulatory specifications, explains programs and results of programs, and documents findings and limitations of department interventions.
Creates, manages, and/or compiles required documentation necessary to maintain critical program milestones, deadlines, and deliverables.
Participates in quality improvement (QI) activities, meetings, and discussions with and between other departments within the organization.
Supports provision of high-quality clinical care and services by facilitating/building strategic relationships with community-based organizations (CBOs).
Evaluates quality project/program activities and results to identify opportunities for improvement.
Raises gaps in processes that may require remediation to quality leadership.
Provides support for quality-related projects.
Provides training and support to new and existing quality member interventions team members.
Demonstrates flexibility when it comes to change management and maintains a positive outlook.
This position may require same day out of office travel 0 - 80% of the time, depending upon state-specific needs.
This position may require multi-day overnight travel on occasion, depending upon state-specific needs.

Required Qualifications

At least 3 years of experience in health care, and at least 2 years of experience in health plan quality member interventions in a managed care setting, or equivalent combination of relevant education and experience.
Demonstrated solid business writing experience.
Proficiency with data analysis, manipulation and interpretation.
Intermediate knowledge and understanding of HEDIS and NCQA.
Critical-thinking, problem-solving and analytical skills.
Attention to detail and organizational skills.
Ability to navigate change with flexibility and a positive outlook.
Ability to work independently in a fast-paced, deadline-driven environment.
Effective verbal and written communication skills.
Microsoft Office suite and applicable software programs proficiency, and ability to learn new information systems and software programs.

Preferred Qualifications

Experience with data reporting, analysis, and interpretation.
Experience with Medicaid, Medicare, and/or Marketplace government-sponsored programs.
Certified Professional in Health Quality (CPHQ).
Certified HEDIS Compliance Auditor (CHCA).

Registered Nurse (RN). If licensed, license must be active and unrestricted in state of practice.
*

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $54,922 - $107,099 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply Now

Refine Your Search

quality and compliance auditor jobs in columbus

Sr Quality Improvement/HEDIS Spec, Health Plan Interventions (Remote In Ohio)

Senior Quality Assurance Specialist - Investigations

Sr. Quality Assurance Engineer - Automation

Commercial Lines Quality Assurance Senior Specialist (hybrid/remote)

Senior Quality Assurance Engineer

Senior IoT Quality Analyst - Cardio Partners - Dublin, OH

Senior Director Quality Affairs

Sr. Quality Engineer - Performance & Automation (Contract)

Senior Director, Quality Assurance

Senior Field Quality Manager

Senior Product Quality Engineer

Senior Supplier Quality Engineer, Altius

Senior Field Quality Manager

Senior Quality Assurance PM, Mechanical – Data Center Construction

Senior Quality Coordinator

Materials Testing Auditor - Independent Contractor

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