Sr. Specialist, Provider Engagement- Quality / HEDIS (Remote in AZ)

Sr. Specialist, Provider Engagement- Quality / HEDIS (Remote in AZ)

02 May 2024
Arizona, Usaz 00000 Usaz USA

Sr. Specialist, Provider Engagement- Quality / HEDIS (Remote in AZ)

Job SummaryMolina's Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs specific to the Provider Network; ensures maintenance of Provider Quality Improvement programs in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key performance measurement activities. This position requires provider engagement experience in a health plan setting.Knowledge/Skills/AbilitiesThe Senior Specialist, Provider Engagement contributes to one or more of these quality improvement functions: Will create actionable HEDIS data and analytic insights. Acts as a lead specialist to provide project-, program-, and / or initiative-related direction and guidance for other specialists within the department and/or collaboratively with other departments. Acts as a lead for provider relations, quality and network development. Implements key quality strategies, which may include initiation and management of provider, member and/or community interventions (e.g., removing barriers to care); preparation for Quality Improvement Compliance surveys; and other federal and state required quality activities. Monitors and ensures that key quality activities are completed on time and accurately in order to present results to key departmental management and other Molina departments as needed. Writes narrative reports to interpret regulatory specifications, explain programs and results of programs, and document findings and limitations of department interventions.Creates, manages, and/or compiles the required documentation to maintain critical quality improvement functions. Leads quality improvement activities, meetings and discussions with and between other departments within the organization. Evaluates project/program activities and results to identify opportunities for improvement. Surfaces to Manager and Director any gaps in processes that may require remediation. Other tasks, duties, projects and programs as assignedJob QualificationsRequired EducationBachelor's Degree or equivalent combination of education and work experience.Required Experience Min. 3 years experience in healthcare with minimum 2 years experience in health plan quality improvement, managed care or equivalent experience. Demonstrated solid business writing experience. Operational knowledge and experience with Excel and Visio (flow chart equivalent).Preferred EducationPreferred field: Clinical Quality, Public Health or Healthcare.Preferred Experience1 year of experience in Medicare and in Medicaid.Experience with data reporting, analysis and/or interpretation.Preferred License, Certification, Association Certified Professional in Health Quality (CPHQ) Nursing License (RN may be preferred for specific roles) Certified HEDIS Compliance Auditor (CHCA)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: $49,929.54 - $97,362.61 a yearActual compensation may vary from posting based on geographic location, work experience, education and/or skill level.#PJCorp#LI-AC1Pay Range: $44,936.59 - $97,362.61 / ANNUALActual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Job Details

  • ID
    JC51609884
  • State
  • City
  • Full-time
  • Salary
    N/A
  • Hiring Company
    Molina Healthcare
  • Date
    2024-05-03
  • Deadline
    2024-07-02
  • Category

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