Specialist, Provider Engagement (Remote in MI)

Lensa; Saginaw (MI); Remote; USD 45,000 - 89,000; Full time

Job summary

A leading company is seeking a Provider Engagement Specialist to implement strategies that improve healthcare quality and outcomes. This role involves working closely with healthcare professionals, tracking engagement activities, and ensuring compliance with policies. Ideal candidates will have experience in healthcare and strong communication skills. Join a dynamic team dedicated to enhancing provider performance and patient care.

Qualifications

• 1-3 years in healthcare, at least 1 year in provider quality performance improvement.
• Knowledge of quality metrics and risk adjustment practices.

Responsibilities

• Implement health plan provider engagement strategy.
• Drive coaching and collaboration with providers.
• Track engagement activities and resolve problems.

Skills

Effective communication

Leadership

Data analytic skills

Education

Associate’s degree

Tools

PowerPoint

Excel

Visio

Job description

Specialist, Provider Engagement (Remote in MI)

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Job Description

Job Summary

The Provider Engagement Specialist role implements the Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. Ensures that Tier 2 and Tier 3 providers have engagement plans to meet annual quality and risk adjustment goals. Drives coaching and collaboration with providers to improve performance through regular meetings and action plans. Addresses practice environment challenges to achieve program goals and improve health outcomes. Tracks engagement activities, facilitates data exchanges, supports training, and resolves problems for the Provider Engagement team. Communicates effectively with healthcare professionals and maintains policy compliance.

Please highlight any experience with vaccination programs.

Knowledge/Skills/Abilities

The Specialist, Provider Engagement contributes to quality improvement functions such as:

• Ensuring assigned providers have engagement plans to meet performance goals.
• Driving provider coaching and collaboration to improve quality and risk adjustment accuracy.
• Addressing practice environment challenges to improve health outcomes.
• Encouraging provider participation in Molina’s risk adjustment and quality efforts.
• Tracking engagement activities using standard tools to measure effectiveness.
• Serving as a subject matter expert and collaborating with internal teams.
• Using standard reports and training materials effectively.
• Facilitating connectivity with internal partners for data exchange and patient engagement.
• Developing and implementing processes per policies.
• Communicating effectively with providers and practice managers.
• Maintaining high compliance standards.
• This position may require same-day out-of-office travel, approximately 0-80% depending on location.

Job Qualifications

Required Education

• Associate’s degree or equivalent experience.

Required Experience

• 1-3 years in healthcare with at least 1 year in provider quality performance improvement.
• Knowledge of quality metrics and risk adjustment practices.
• Data analytic skills.
• Operational knowledge of PowerPoint, Excel, Visio.
• Effective communication skills.
• Strong leadership skills.

Preferred Education

Field: Clinical Quality, Public Health, Healthcare.

Preferred Experience

Experience in Medicare and Medicaid (1 year).

Preferred Certifications

• Certified Professional in Health Quality (CPHQ)
• Nursing License (RN preferred for some roles)
• Certified HEDIS Compliance Auditor (CHCA)
• Vaccine for Children Program experience (VFC)

Current Molina employees should apply through the intranet.

Molina Healthcare offers competitive benefits. We are an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $45,390 - $88,511.46 per year. Actual compensation varies based on location, experience, education, and skills.

Additional Details

• Seniority level: Entry level
• Employment type: Full-time
• Job function: Other
• Industries: IT Services and IT Consulting

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