Senior Specialist, Health Plan Quality Program Management & Performance (RN) - R
Molina Healthcare · United States · US
Quality Improvement
Remote
physician
Nurse
Demand78
Career growth72
Healthcare fit86
Remote potential45
5-year outlook
Managed care quality and HEDIS/NCQA expertise should remain marketable over the next 3-5 years; pay growth is likely tied to CPHQ certification, audit leadership, and state/federal compliance experience, though exact salary varies by state and plan.
Clinical license
Required
Applicant reach
moderate
Seniority
senior
Employment type
full-time
Date found
2026-10-23
Intelligence details
Flexible work details
- Side income
- Classified as side-income friendly
- Engagement type
- Contract
- Hours
- Variable hours
- Eligible countries
- United States
- License jurisdiction
- US
- Profession fit
- physician, Nurse
- Rate period
- Annual
Why this was classified this way
- contract
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
Worth applying for RNs with managed care quality, auditing, HEDIS/NCQA, or peer review experience who want a non-bedside health plan career. Less suitable for nurses without prior quality management exposure.
Who should apply
RNs with quality management, managed care, HEDIS/NCQA, clinical audit, peer review, compliance, or quality improvement experience who want to move into health plan quality program leadership.
CV angle
Reframe clinical RN experience around quality monitoring, patient safety, compliance, medical record review, audit findings, process improvement, cross-functional collaboration, and any HEDIS/NCQA or managed care exposure. Emphasize measurable quality or safety projects without inventing non-clinical titles.
Skills to highlight
- HEDIS and NCQA knowledge
- Clinical quality investigations
- Quality auditing and medical record review
- Peer review and credentialing support
- Process improvement
- State and federal quality compliance
- Cross-functional collaboration
- Data analysis and quality reporting
Role summary
A senior RN quality role at a health plan focused on quality program management, clinical quality investigations, audits, HEDIS/NCQA compliance, peer review, credentialing oversight, and state/federal quality requirements.
We publish our own intelligence summary, never the full job description. Always confirm details with the employer when you apply.