Detroit, MI, 48208, USA
11 days ago
Specialist, Provider Engagement (Remote in MI)
**JOB DESCRIPTION** **Job Summary** 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. **Experience with quality, providers and HEDIS is very important for this position. Please highlight this experience on your resume.** **KNOWLEDGE/SKILLS/ABILITIES** The Specialist, Provider Engagement contributes to one or more of these quality improvements functions: + Implements key quality strategies, which may include initiation and management of provider, member and/or community interventions (e.g., removing barriers to care); and other federal and state required quality activities. + Monitors and ensures that key quality 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 quality improvement functions. + Leads quality improvement activities, meetings, and discussions with and between other departments within the organization or with and between key provider network partners. + 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. + This position may require same day out of office travel approximately 0 - 80% of the time, depending upon location. + This position may require multiple day out of town overnight travel approximately on occasion, depending upon location. **JOB QUALIFICATIONS** **Required Education** Bachelor's Degree or equivalent combination of education and work experience. **Required Experience** + Min. 3 years’ experience in healthcare with 1 year experience in health plan quality improvement (HEDIS), 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** 1 year of experience in Medicare and in Medicaid. **Preferred License, Certification, Association** + Certified Professional in Health Quality (CPHQ) + Nursing License (RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) + Experience with EPSDT 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. \#PJCore \#LI-AC1 Pay Range: $43,888 - $88,511.46 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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