Senior Provider Engagement Specialist
Molina Healthcare
**_***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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