Senior Provider Engagement & Quality Improvement Lead

Molina Healthcare; Las Cruces (NM); Remote; USD 55,000 - 100,000; Full time

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare in the United States is seeking a Senior Provider Engagement Specialist to support implementation of provider engagement strategies that drive HEDIS quality scores, risk adjustment and value-based care outcomes.

You will coach Tier 1–3 providers, coordinate with health plan teams, and use data analytics to improve performance. Travel up to 80% may be required depending on state and plan requirements.

Qualifications

• 3+ years improving population-level HEDIS scores via provider engagement.
• Experience with quality measures across Medicaid, Medicare and Marketplace.
• Proficient data analysis, interpretation and reporting.

Responsibilities

• Support provider engagement activities to drive value-based strategies and risk adjustment/quality initiatives.
• Ensure providers have engagement plans to meet annual quality and risk goals.
• Coach providers and coordinate with health plan teams to improve quality performance and risk accuracy.
• Collaborate with provider front-office staff to schedule high-gap members for timely visits.
• Track engagement and training activities using standard tools and report outcomes.
• Serve as subject matter expert on provider engagement across plans.

Skills

Population health analytics

HEDIS quality improvement

Data analysis

Communication

Problem solving

Organizational skills

Cross-functional collaboration

Education

Bachelor’s degree in Nursing/Health Administration

Tools

Excel

Power BI

MS Office

Job description

Molina Healthcare in the United States is seeking a Senior Provider Engagement Specialist to support implementation of provider engagement strategies that drive HEDIS quality scores, risk adjustment and value-based care outcomes.

You will coach Tier 1–3 providers, coordinate with health plan teams, and use data analytics to improve performance. Travel up to 80% may be required depending on state and plan requirements.