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Specialist, Practice Transformation (Must reside in Iowa)

Molina Healthcare

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**JOB DESCRIPTION**

  • *Job Summary**
  • *The Specialist, Practice Transformation implements Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. Drives provider practices to ensure assigned Tier 2 & Tier 3 Practice Transformation plan is in place and carried out to meet annual quality & risk adjustment performance goals.**
  • *Job Duties**

+ Ensures assigned Tier 2 & Tier 3 providers have a Practice Transformation plan to meet annual quality & risk adjustment performance goals.

+ Drives provider partner coaching and collaboration to improve quality performance and risk adjustment accuracy through consistent provider meetings, action item development and execution.

+ Addresses challenges/barriers in the practice environment impeding successful attainment of program goals and understands solutions required to improve health outcomes.

+ Drives provider participation in Molina risk adjustment and quality efforts (e.g. Supplemental data, EMR connection, Clinical Profiles programs) and use of the Molina Provider Collaboration Portal.

+ Tracks all engagement and training activities using standard Molina Provider Engagement tools to measure effectiveness both within and across Molina Health Plans.

+ Serves as a Practice Transformation subject matter expert; works collaboratively within the Health Plan and with shared service partners to ensure alignment to business goals.

+ Accountable for use of standard Molina Practice Transformation reports and training materials.

+ Facilitates connectivity to internal partners to support appropriate data exchanges, documentation education and patient engagement activities.

+ Develops, organizes, analyzes, documents and implements processes and procedures as prescribed by Plan and Corporate policies.

+ Communicates comfortably and effectively with Physician Leaders, Providers, Practice Managers, Medical Assistants within assigned provider practices.

+ Maintains the highest level of compliance.

+ This position may require same day out of office travel approximately 0 - 80% of the time, depending upon location.

  • *JOB QUALIFICATIONS**
  • *REQUIRED QUALIFICATIONS:**

+ Associate’s degree or equivalent combination of education and work experience.

+ Min 1-3 years experience in healthcare with minimum 1 year experience improving provider Quality performance through provider engagement, practice transformation, managed care quality improvement, or equivalent experience.

+ Experience with various managed healthcare provider compensation methodologies including but not limited to: fee-for service, value-based care, and capitation

+ Strong working knowledge of Quality metrics and risk adjustment practices across all business lines

+ Demonstrates data analytic skills

+ Operational knowledge and experience with PowerPoint, Excel, Visio

+ Effective communication skills

  • *PREFERRED QUALIFICATIONS:**

+ Degree in Preferred field: Clinical Quality, Public Health or Healthcare.

+ 1 year of experience in Medicaid and/or Medicare managed care

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $47,433 - $97,362.61 / ANNUAL

  • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
  • *JOB DESCRIPTION**
  • *Job Summary**
  • *The Specialist, Practice Transformation implements Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. Drives provider practices to ensure assigned Tier 2 & Tier 3 Practice Transformation plan is in place and carried out to meet annual quality & risk adjustment performance goals.**
  • *Job Duties**

+ Ensures assigned Tier 2 & Tier 3 providers have a Practice Transformation plan to meet annual quality & risk adjustment performance goals.

+ Drives provider partner coaching and collaboration to improve quality performance and risk adjustment accuracy through consistent provider meetings, action item development and execution.

+ Addresses challenges/barriers in the practice environment impeding successful attainment of program goals and understands solutions required to improve health outcomes.

+ Drives provider participation in Molina risk adjustment and quality efforts (e.g. Supplemental data, EMR connection, Clinical Profiles programs) and use of the Molina Provider Collaboration Portal.

+ Tracks all engagement and training activities using standard Molina Provider Engagement tools to measure effectiveness both within and across Molina Health Plans.

+ Serves as a Practice Transformation subject matter expert; works collaboratively within the Health Plan and with shared service partners to ensure alignment to business goals.

+ Accountable for use of standard Molina Practice Transformation reports and training materials.

+ Facilitates connectivity to internal partners to support appropriate data exchanges, documentation education and patient engagement activities.

+ Develops, organizes, analyzes, documents and implements processes and procedures as prescribed by Plan and Corporate policies.

+ Communicates comfortably and effectively with Physician Leaders, Providers, Practice Managers, Medical Assistants within assigned provider practices.

+ Maintains the highest level of compliance.

+ This position may require same day out of office travel approximately 0 - 80% of the time, depending upon location.

  • *JOB QUALIFICATIONS**
  • *REQUIRED QUALIFICATIONS:**

+ Associate’s degree or equivalent combination of education and work experience.

+ Min 1-3 years experience in healthcare with minimum 1 year experience improving provider Quality performance through provider engagement, practice transformation, managed care quality improvement, or equivalent experience.

+ Experience with various managed healthcare provider compensation methodologies including but not limited to: fee-for service, value-based care, and capitation

+ Strong working knowledge of Quality metrics and risk adjustment practices across all business lines

+ Demonstrates data analytic skills

+ Operational knowledge and experience with PowerPoint, Excel, Visio

+ Effective communication skills

  • *PREFERRED QUALIFICATIONS:**

+ Degree in Preferred field: Clinical Quality, Public Health or Healthcare.

+ 1 year of experience in Medicaid and/or Medicare managed care

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $47,433 - $97,362.61 / ANNUAL

  • Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Job Type

Job Type
Full Time
Salary Range
USD 47,433 - 97,362.61 yearly
Location
Des Moines, IA

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