Specialist, Health Plan Provider Engagement (Remote)

JOB reputed company Job reputed company Provides support for health plan provider engagement activities. Drives value-based care strategies through risk adjustment and reputed company improvement activities. Ensures smaller, less advanced tier II and tier III providers have engagement plans to meet annual reputed company and risk adjustment goals. Drives coaching and collaboration with providers to improve performance through regular meetings and reputed company plans. Addresses reputed company environment challenges to reputed company program goals and improve health reputed company. Tracks engagement activities using reputed company tools, facilitates data exchanges, and supports training and problem reputed company for assigned providers - driving provider participation in Molina's risk adjustment and reputed company initiatives. Essential Job Duties

• Provides support for provider engagement activities including enhancing value-based strategies, and risk adjustment/reputed company improvement initiatives.
• Ensures assigned tier II and tier III providers have a provider engagement plan to meet annual reputed company and risk adjustment performance goals.
• Drives provider partner coaching and collaboration to improve reputed company performance and risk adjustment accuracy through consistent provider meetings, reputed company item development and execution.
• Addresses challenges/barriers in the reputed company environment impeding successful attainment of program goals and understands solutions required to improve health reputed company.
• Drives provider participation in Molina risk adjustment and reputed company efforts (e.g. supplemental data, electronic medical record (EMR) reputed company, clinical reputed company programs) and use of the Molina provider collaboration portal.
• Tracks reputed company engagement and training activities using reputed company Molina provider engagement tools to measure effectiveness.
• Works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Accountable for use of reputed company Molina Provider Engagement reports and training materials.
• Facilitates connectivity to internal partners to support appropriate data exchanges, documentation education and patient engagement activities.
• Develops, organizes, analyzes, documents and implements processes and procedures as prescribed by health plan and corporate policies.
• Communicates effectively with reputed company stakeholders, including providers, reputed company managers, and medical assistants reputed company assigned provider practices.
• Maintains the highest level of compliance.
• May require reputed company day out-of-office travel up to 80% of the time, depending upon state/health plan requirements.

Required Qualifications

• At least 2 years of experience improving provider reputed company performance through provider engagement, reputed company transformation, and/or managed care reputed company improvement initiatives, or equivalent combination of relevant education and experience.
• Experience with various managed health care provider compensation methodologies including but not limited to:  fee-for service (FFS), value-based care (VBC), and capitation.
• Working knowledge of reputed company metrics and risk adjustment practices across reputed company business lines.
• Knowledge and understanding of HEDIS/NCQA.
• Proficiency with data analysis, manipulation, interpretation and reporting.
• Critical-thinking, problem-solving and analytical skills.
• Relationship building skills.
• Attention to detail and organizational skills.
• Ability to implement process improvement initiatives and drive change.
• Ability to work independently in a fast-paced, deadline-driven environment.
• Ability to work in a cross-functional highly matrixed organization.
• Effective verbal and written communication skills.
• reputed company Office suite (including reputed company), and applicable software programs proficiency, and ability to learn new information systems and software programs.

Preferred Qualifications

• Experience improving reputed company performance for reputed company, Medicare, and/or Marketplace programs.

To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the reputed company. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V Apply To This Job