Value-Based Provider Engagement Leader

Molina Healthcare; Louisville (KY); Remote; USD 63,000 - 115,000; Full time

Job summary

Molina Healthcare in Louisville, KY seeks a subject matter expert to lead provider engagement strategies and risk adjustment outcomes. You will use data and analytics to drive value-based care and coach providers through improvement plans, meetings and action items.

You will mentor Engagement Specialists, track activities with standard tools, collaborate with health plans, and ensure compliance while traveling up to 80% as required by state plans.

Qualifications

• 6+ years improving population-level HEDIS quality scores and risk adjustment accuracy through provider engagement.
• Experience with FFS, VBC, and capitation payment models.
• Strong knowledge of quality metrics and risk adjustment across Medicaid, Medicare, and Marketplace.

Responsibilities

• Lead provider engagement initiatives to improve quality and risk-adjustment outcomes.
• Mentor and train Provider Engagement Specialists and Senior Specialists.
• Track engagement activities using standard Molina tools to measure effectiveness.

Skills

Provider Engagement

Data Analysis

Power BI

Excel

Project Management

Communication

Education

Bachelor's degree in Nursing or Health Administration

Tools

Power BI

Excel

Job description

Molina Healthcare in Louisville, KY seeks a subject matter expert to lead provider engagement strategies and risk adjustment outcomes. You will use data and analytics to drive value-based care and coach providers through improvement plans, meetings and action items.

You will mentor Engagement Specialists, track activities with standard tools, collaborate with health plans, and ensure compliance while traveling up to 80% as required by state plans.