Provider Engagement & Quality Improvement Lead

Molina Healthcare; Seattle (WA); On-site; USD 83,252 - 101,788; Full time

Job summary

Molina Healthcare is seeking a provider engagement specialist to support implementation of health plan provider engagement strategies and activities. You will drive value-based care through risk adjustment and quality improvement, focusing on Tier 2 and 3 providers, and developing engagement plans to meet annual goals.

The role involves coaching providers, coordinating with front-office staff, and tracking activities using Molina tools.

Qualifications

• 2+ years of experience improving HEDIS quality scores through provider engagement.
• Experience with multiple provider compensation methodologies (FFS, VBC, capitation).
• Knowledge of quality metrics and risk adjustment practices across Medicaid, Medicare, and Marketplace.

Responsibilities

• Support provider engagement activities to enhance value-based strategies, risk adjustment and quality improvement.
• Ensure Tier 2/3 providers have a provider engagement plan to meet annual goals.
• Coach providers to improve Medicaid, Medicare and Marketplace quality performance and risk adjustment accuracy through meetings and action items.

Skills

Data analysis

Problem solving

Attention to detail

Relationship building

Communication skills

Independent work

Education

Bachelor's degree in Nursing or Health Administration

Tools

Excel

Power BI

EMR integration

Job description

Molina Healthcare is seeking a provider engagement specialist to support implementation of health plan provider engagement strategies and activities. You will drive value-based care through risk adjustment and quality improvement, focusing on Tier 2 and 3 providers, and developing engagement plans to meet annual goals.

The role involves coaching providers, coordinating with front-office staff, and tracking activities using Molina tools.