Provider Engagement Specialist – Risk & Quality Improvement

Molina Healthcare Inc

California

Remote

USD 85,000 - 120,000

Full time

14 days+

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Job summary

Molina Healthcare Inc. seeks a Provider Engagement Specialist to support implementation of value-based care and risk adjustment initiatives across Tier 2/3 providers, using data analytics to drive physician engagement and performance improvement.

You will coach providers, coordinate with Health Plan Community and Member Engagement, and ensure compliance while traveling up to 80% as required.

Qualifications

At least 2 years of experience improving population-level HEDIS quality scores through provider engagement.
Experience with managed health care provider compensation methodologies and risk adjustment practices.
Proficiency with data analysis, manipulation, interpretation and reporting.

Responsibilities

Provide support for provider engagement activities including value-based strategies and risk adjustment/quality improvement initiatives.
Ensure Tier 2/3 providers have an engagement plan to meet annual performance goals.
Coach and collaborate with providers to improve Medicaid, Medicare and Marketplace quality and risk adjustment accuracy.
Coordinate with Health Plan Community and Member Engagement resources to drive member-side support.
Track engagement and training activities using standard provider engagement tools.