Molina Healthcare
Specialist, Provider Engagement (must reside in South Carolina - upstate or lowc
Molina Healthcare, Florence, South Carolina, United States, 29506
Overview
Provider Engagement Specialist implements the Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. Ensures Tier 2 and Tier 3 providers have engagement plans to meet annual quality and risk adjustment goals. Drives coaching and collaboration with providers, addresses practice environment challenges, tracks engagement activities, supports training and problem resolution, and maintains compliance with policies. Responsibilities
Ensure assigned Tier 2 & Tier 3 providers have a Provider Engagement plan to meet annual quality & risk adjustment performance goals. Drive provider partner coaching and collaboration to improve quality performance and risk adjustment accuracy through consistent provider meetings, action item development and execution. Address challenges/barriers in the practice environment impeding successful attainment of program goals and determine solutions to improve health outcomes. Drive provider participation in Molina risk adjustment and quality efforts (e.g. Supplemental data, EMR connection, Clinical Profiles programs) and use of the Molina Provider Collaboration Portal. Track all engagement and training activities using standard Molina Provider Engagement tools to measure effectiveness both within and across Molina Health Plans. Serve as a Provider Engagement subject‑matter expert; collaborate within the Health Plan and with shared service partners to ensure alignment to business goals. Accountable for use of standard Molina Provider Engagement reports and training materials. Facilitate connectivity to internal partners to support appropriate data exchanges, documentation education and patient engagement activities. Develop, organize, analyze, document and implement processes and procedures as prescribed by Plan and Corporate policies. Communicate comfortably and effectively with Physician Leaders, Providers, Practice Managers, Medical Assistants within assigned provider practices. Maintain the highest level of compliance. Provide same day out‑of‑office travel approximately 0‑80% of the time, depending on location. Qualifications
Associates degree or equivalent combination of education and work experience. 1‑3 years experience in healthcare with minimum 1 year experience improving provider quality performance through provider engagement, practice transformation, managed care quality improvement, or equivalent experience. Working knowledge of quality metrics and risk adjustment practices across all business lines. Demonstrates data analytic skills. Operational knowledge and experience with PowerPoint, Excel, Visio. Effective communication skills. Strong leadership skills. EEO Statement
Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range
Pay Range: $43,121 - $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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Provider Engagement Specialist implements the Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. Ensures Tier 2 and Tier 3 providers have engagement plans to meet annual quality and risk adjustment goals. Drives coaching and collaboration with providers, addresses practice environment challenges, tracks engagement activities, supports training and problem resolution, and maintains compliance with policies. Responsibilities
Ensure assigned Tier 2 & Tier 3 providers have a Provider Engagement plan to meet annual quality & risk adjustment performance goals. Drive provider partner coaching and collaboration to improve quality performance and risk adjustment accuracy through consistent provider meetings, action item development and execution. Address challenges/barriers in the practice environment impeding successful attainment of program goals and determine solutions to improve health outcomes. Drive provider participation in Molina risk adjustment and quality efforts (e.g. Supplemental data, EMR connection, Clinical Profiles programs) and use of the Molina Provider Collaboration Portal. Track all engagement and training activities using standard Molina Provider Engagement tools to measure effectiveness both within and across Molina Health Plans. Serve as a Provider Engagement subject‑matter expert; collaborate within the Health Plan and with shared service partners to ensure alignment to business goals. Accountable for use of standard Molina Provider Engagement reports and training materials. Facilitate connectivity to internal partners to support appropriate data exchanges, documentation education and patient engagement activities. Develop, organize, analyze, document and implement processes and procedures as prescribed by Plan and Corporate policies. Communicate comfortably and effectively with Physician Leaders, Providers, Practice Managers, Medical Assistants within assigned provider practices. Maintain the highest level of compliance. Provide same day out‑of‑office travel approximately 0‑80% of the time, depending on location. Qualifications
Associates degree or equivalent combination of education and work experience. 1‑3 years experience in healthcare with minimum 1 year experience improving provider quality performance through provider engagement, practice transformation, managed care quality improvement, or equivalent experience. Working knowledge of quality metrics and risk adjustment practices across all business lines. Demonstrates data analytic skills. Operational knowledge and experience with PowerPoint, Excel, Visio. Effective communication skills. Strong leadership skills. EEO Statement
Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range
Pay Range: $43,121 - $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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