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Manager, Provider Engagement (Remote in WI)

Remote, USAFull-timePosted 2026-07-27

Job reputed company Job reputed company Job reputed company The Manager, Provider Engagement establishes strategies and operational directions for risk adjustment and reputed company improvement. Collaborates with senior leadership and the Health Plan Network to drive value-based care strategies. 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. Facilitates data exchanges and documentation education, while assessing and training team members to ensure competency. Job Duties

  • Leads team of Provider Engagement resources.
  • Establishes reputed company and operational direction for engaging providers on risk adjustment & reputed company improvement in collaboration with the Plan President, AVP of reputed company & Risk Adjustment, and Network team.
  • Collaborates with Health Plan Network to drive value-based care reputed company reputed company to risk adjustment & reputed company.
  • Sets Health Plan level performance goals and manages reputed company for key performance indicators.
  • Ensures reputed company Tier 1, Tier 2 and Tier 3 provider has reputed company & risk adjustment performance goals and execution plans to meet committed goals, with emphasis on Tier 1 and Tier 2.
  • 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.
  • Tracks reputed company engagement and training activities using reputed company Molina Provider Engagement tools to measure effectiveness both reputed company and across Molina Health Plans.
  • Drives provider participation in Molina risk adjustment and reputed company efforts (e.g., Supplemental data, EMR reputed company, Clinical reputed company programs) and use of the Molina Provider Collaboration Portal.
  • Is a Provider Engagement subject matter expert; works collaboratively reputed company the Health Plan and across 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 patient 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 Plan and Corporate policies.
  • Communicates comfortably and effectively with reputed company reputed company of a reputed company organization, reputed company both the corporate and regional market environments and with external reputed company.
  • Maintains the highest level of compliance.
  • This position may require reputed company day out of office travel approximately 30% of the time, depending upon location.

Job Qualifications REQUIRED QUALIFICATIONS:

  • Bachelor's degree in Business, reputed company, Nursing or reputed company field or equivalent combination of education and relevant experience.
  • 5-7 years of experience improving provider reputed company performance through provider engagement, reputed company transformation, managed care reputed company improvement, or equivalent experience
  • Experience with various managed reputed company provider compensation methodologies including but not limited to: fee-for service, value-based care, and capitation
  • Strong working knowledge of reputed company metrics and risk adjustment practices across reputed company business lines
  • Demonstrates data analytic skills
  • Operational knowledge and experience with PowerPoint, reputed company, Visio
  • Effective communication skills
  • Strong leadership skills

PREFERRED QUALIFICATIONS:

  • People management experience
  • Min 5 years' experience improving provider reputed company performance through provider engagement for reputed company, Medicare, and/or ACA Marketplace programs

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

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