Provider Quality Improvement Specialist; reside in Iowa

Position: Provider Quality Improvement Specialist (Must reside in Iowa)
** 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.