Seattle, WA, 98194, USA
11 days ago
Senior Provider Engagement Specialist
**_***Remote and must live in Pacific Time Zone***_** **Job Description** **Job Summary** **This position will be supporting Molina's Washington Health Plan** Molina's Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs specific to the Provider Network; ensures maintenance of Provider Quality Improvement programs in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement activities. Manages assigned provider relationships across the network – address issues, develop and provide education and facilitate meeting established goals. **Knowledge/Skills/Abilities** The Senior Specialist, Provider Engagement contributes to one or more of these quality improvement functions: + Support & engage assigned provider groups to achieve quality measure targets. Act as primary contact to assigned providers, communicate information effectively, address questions & concerns, and collaborate to meet measure goals. + Support internal Quality and VBC-related activities. + Acts as a lead specialist to provide project-, program-, and / or initiative-related direction and guidance for other specialists within the department and/or collaboratively with other departments. + Implements key quality strategies, which may include initiation and management of provider, member and/or community interventions (e.g., removing barriers to care); preparation for Quality Improvement Compliance surveys; and other federal and state required quality activities. + Monitors and ensures that key quality activities are completed on time and accurately in order 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 quality improvement functions. + Leads quality improvement activities, meetings and discussions with and between other departments within the organization. + Evaluates project/program activities and results to identify opportunities for improvement. + Surfaces to Manager and Director any gaps in processes that may require remediation. + Other tasks, duties, projects and programs as assigned.. + **Job Qualifications** **Required Education** Bachelor's Degree or equivalent combination of education and work experience. **Required Experience** • Min. 3 years experience in healthcare with minimum 2 years experience in health plan quality improvement, managed care or equivalent experience. • Demonstrated solid business writing experience. • Operational knowledge and experience with Excel and Visio (flow chart equivalent). **Preferred Education** Preferred field: Clinical Quality, Public Health or Healthcare. **Preferred Experience** + Understanding and experience with Quality and HEDIS measures. + Proficient with data and reports + Knowledge of risk adjustment + 1 year of experience in Medicare and in Medicaid. + Experience with data reporting, analysis and/or interpretation. + 1 year of experience in Medicare and in Medicaid. + Experience with data reporting, analysis and/or interpretation. **Preferred License, Certification, Association** • Certified Professional in Health Quality (CPHQ) • Nursing License (RN may be preferred for specific roles) • Certified HEDIS Compliance Auditor (CHCA) 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: $49,929.54 - $97,362.61 a year* *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Pay Range: $67,725 - $123,164 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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