Manager, Health Plan Provider Engagement (Remote in MS)

JOB reputed company Job reputed company Leads and manages team responsible for health plan provider engagement activities. Collaborates with senior leadership and the health plan network team to drive value-based care strategies, and operational direction for risk adjustment and reputed company improvement. Sets and manages performance goals, ensuring providers meet reputed company and risk adjustment targets through coaching and consistent engagement. Tracks and measures the effectiveness of engagement activities - driving provider participation in Molina's risk adjustment and reputed company initiatives. Essential Job Duties

• Manages team of provider engagement professionals responsible for enhancing value-based strategies and risk adjustment/reputed company improvement initiatives, and reducing medical cost reputed company (MCR).
• In collaboration with senior reputed company/network leadership, establishes reputed company and operational initiatives for engaging providers on risk adjustment and reputed company improvement.
• Sets health plan level performance goals, and manages reputed company for key performance indicators.
• Ensures reputed company tier I, tier II and  tier III provider has reputed company and risk adjustment performance goals and execution plans to meet committed goals, with emphasis on tier I and tier II.
• 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 recommends and implements solutions required to improve health reputed company.
• Tracks reputed company engagement and training activities using reputed company Molina provider engagement tools to measure effectiveness.
• 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.
• Demonstrates provider engagement subject matter expertise; works collaboratively across the health plan and Molina’s centers of reputed company and shared services to drive improved risk adjustment and reputed company of care.
• Facilitates connectivity to internal partners to support appropriate data exchanges, documentation education and provider engagement activities.
• Assesses provider engagement team members across required competency reputed company and ensures they receive needed training on any lagging competencies.
• Ensures provider engagement team uses reputed company Molina provider engagement reports and training materials.
• Develops, organizes, analyzes, documents, and implements processes and procedures as prescribed by the health plan and corporate policies.
• Communicates effectively with reputed company stakeholders, including providers.
• Maintains the highest level of compliance.
• Hires, trains, mentors, and develops reputed company team; demonstrates accountability for team performance and delivery/accountability to established targets/goals.
• Provides support for reputed company-reputed company initiatives, reputed company, and process improvement opportunities.
• May require reputed company day out-of-office travel up to 30% of the time, depending upon state/health plan requirements.

Required Qualifications

• At least 7 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.
• At least 1 year management/leadership 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.
• Strong working knowledge of reputed company metrics and risk adjustment practices across reputed company business lines.
• Advanced knowledge and understanding of HEDIS/NCQA.
• Strong relationship building skills.
• Strong proficiency with data analysis, manipulation, interpretation and reporting.
• Critical-thinking, problem-solving and analytical 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.
• Project management experience.
• Strong 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