Value-Based Provider Engagement Lead

Molina Healthcare; Louisville (KY); Remote; USD 110,000 - 140,000; Full time

Job summary

Molina Healthcare is seeking a seasoned Provider Engagement Leader in Louisville, KY to guide and implement strategic engagement plans for value-based care and risk adjustment across Medicaid, Medicare, and Marketplace lines.

The role emphasizes coaching providers, driving quality performance, and collaborating with internal teams to remove barriers and improve health outcomes, with substantial travel as required.

Qualifications

• 6+ years improving population-level HEDIS quality scores and burden of illness documentation through provider engagement.
• Experience with value-based care, CMS STARS, Medicaid/Medicare quality measures.
• Strong data analysis, reporting, and problem-solving skills.
• Proficiency with Microsoft Office and BI tools (Excel, Power BI).

Responsibilities

• Lead provider engagement activities and coach teams to meet annual quality and risk adjustment goals.
• Develop and implement provider engagement plans for Tier 1 (and Tier 2) providers as needed.
• Drive risk adjustment and quality improvement initiatives across plans.
• Collaborate with health plan staff, providers, and front-office teams to close care gaps.
• Mentor Specialists and track engagement using standard tools.

Skills

Provider engagement

HEDIS quality

Quality metrics

Data analysis

Project management

Excel

Power BI

Communication

Problem solving

Education

Bachelor's degree (Nursing/Health Admin)

Tools

Power BI

Excel

CRM systems

Job description

Molina Healthcare is seeking a seasoned Provider Engagement Leader in Louisville, KY to guide and implement strategic engagement plans for value-based care and risk adjustment across Medicaid, Medicare, and Marketplace lines.

The role emphasizes coaching providers, driving quality performance, and collaborating with internal teams to remove barriers and improve health outcomes, with substantial travel as required.