Sr. Specialist, Quality Provider Engagement- RN / LPN Preferred (Remote in MS)

Molina Healthcare; Long Beach (CA); Remote; USD 60,000 - 100,000; Full time

Job summary

An established industry player in healthcare is seeking a dedicated professional to enhance provider engagement and quality performance. This role offers a unique opportunity for career advancement while making a significant impact on healthcare outcomes. You will collaborate with healthcare professionals, drive coaching initiatives, and facilitate data exchanges to improve performance metrics. If you are passionate about quality improvement and have strong leadership skills, this is the perfect opportunity for you to thrive in a supportive and collaborative environment.

Benefits

Competitive benefits and compensation package

Opportunity for career advancement

Collaborative work environment

Qualifications

• 3+ years of experience in provider quality performance improvement.
• Strong knowledge of quality metrics and risk adjustment practices.

Responsibilities

• Drive provider partner coaching and collaboration to improve quality performance.
• Ensure providers have a Provider Engagement plan to meet performance goals.

Skills

Provider Engagement

Quality Improvement

Leadership Skills

Effective Communication

Education

Bachelor’s degree in Business, Healthcare, Nursing, or related field

Job description

Employer Industry: Healthcare

Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Competitive benefits and compensation package
- Chance to make a positive impact on quality and risk adjustment outcomes
- Collaborative work environment with healthcare professionals
- Frequent engagement with providers to enhance performance
- Position may require same-day out-of-office travel approximately 0-80% of the time

What to Expect (Job Responsibilities):
- Ensure assigned Tier 2 & Tier 3 providers have a Provider Engagement plan to meet annual quality & risk adjustment performance goals
- Drive provider partner coaching and collaboration to improve quality performance and risk adjustment accuracy
- Address challenges in the practice environment to achieve program goals and improve health outcomes
- Track all engagement and training activities using standard tools to measure effectiveness
- Facilitate connectivity to internal partners to support data exchanges and patient engagement activities

What is Required (Qualifications):
- Bachelor’s degree in Business, Healthcare, Nursing, or related field, or equivalent combination of education and relevant experience
- Minimum 3 years of experience improving provider quality performance through engagement, practice transformation, or managed care quality improvement
- Experience with various managed healthcare provider compensation methodologies, including fee-for-service and value-based care
- Strong working knowledge of quality metrics and risk adjustment practices across all business lines
- Effective communication and strong leadership skills

How to Stand Out (Preferred Qualifications):
- Minimum 3 years of experience improving quality performance for Medicaid, Medicare, and/or ACA Marketplace programs

#Healthcare #ProviderEngagement #QualityImprovement #CareerOpportunity #LeadershipSkills

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