Specialist, Provider Engagement (Remote)
Molina Healthcare, Florida, NY, United States
Job Summary
The Provider Engagement Specialist role implements Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. Ensures smaller, less advanced Tier 2 and Tier 3 providers have engagement plans to meet annual quality and risk adjustment goals. Drives coaching and collaboration with providers to improve performance through regular meetings and action plans. Addresses practice environment challenges to achieve program goals and improve health outcomes. Tracks engagement activities using standard tools, facilitates data exchanges, and supports training and problem resolution for the Provider Engagement team. Communicates effectively with healthcare professionals and maintains compliance with policies. Job Duties
Ensure assigned Tier 2 & Tier 3 providers have a Provider Engagement plan to meet annual quality and 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 and barriers in the practice environment impeding successful attainment of program goals and identify solutions to improve health outcomes. Encourage 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 within and across Molina Health Plans. Serve as a Provider Engagement subject matter expert; collaborate with Health Plan teams and shared service partners to ensure alignment to business goals. Be 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, and Medical Assistants within assigned provider practices. Maintain the highest level of compliance. This position may require same-day out-of-office travel approximately 0–80% of the time, depending upon location. Job Qualifications
REQUIRED QUALIFICATIONS: Associate's degree or an equivalent combination of education and work experience. 1–3 years of healthcare experience with a minimum of 1 year 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. Pay Range: $45,390 - $88,511.46 per year. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
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The Provider Engagement Specialist role implements Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. Ensures smaller, less advanced Tier 2 and Tier 3 providers have engagement plans to meet annual quality and risk adjustment goals. Drives coaching and collaboration with providers to improve performance through regular meetings and action plans. Addresses practice environment challenges to achieve program goals and improve health outcomes. Tracks engagement activities using standard tools, facilitates data exchanges, and supports training and problem resolution for the Provider Engagement team. Communicates effectively with healthcare professionals and maintains compliance with policies. Job Duties
Ensure assigned Tier 2 & Tier 3 providers have a Provider Engagement plan to meet annual quality and 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 and barriers in the practice environment impeding successful attainment of program goals and identify solutions to improve health outcomes. Encourage 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 within and across Molina Health Plans. Serve as a Provider Engagement subject matter expert; collaborate with Health Plan teams and shared service partners to ensure alignment to business goals. Be 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, and Medical Assistants within assigned provider practices. Maintain the highest level of compliance. This position may require same-day out-of-office travel approximately 0–80% of the time, depending upon location. Job Qualifications
REQUIRED QUALIFICATIONS: Associate's degree or an equivalent combination of education and work experience. 1–3 years of healthcare experience with a minimum of 1 year 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. Pay Range: $45,390 - $88,511.46 per year. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
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