Senior Specialist, Health Plan Provider Engagement (Remote in NM)

Job Summary

Provides senior level support for implementation of health plan provider engagement strategies and activities to drive necessary quality and risk adjustment outcomes.

Uses a consultative approach emphasizing physician engagement and behavior change through actionable data and analytics.

Drives value-based care strategies through risk adjustment and quality improvement activities.

Ensures assigned Tier 1 & Tier 2 providers have engagement plans ensuring they meet annual quality and risk adjustment goals.

Drives coaching and collaboration with providers to improve performance through regular meetings and action plans.

Addresses practice environment challenges to achieve program goals and improve health outcomes.

Tracks engagement activities using standard tools, facilitates data exchanges, and supports training and problem resolution for assigned providers - driving provider participation in Molina's risk adjustment and quality initiatives.

Essential Job Duties

• Supports provider engagement activities including enhancing value-based strategies, and risk adjustment/quality improvement initiatives.
• Ensures assigned Tier 1, Tier 2, and where applicable Tier 3, providers have a provider engagement plan to meet annual quality and risk adjustment performance goals.
• Drives provider partner coaching and collaboration to improve Medicaid, Medicare and Marketplace quality performance and risk adjustment accuracy through consistent provider meetings, action item development and execution.
• Works with provider front-office staff to get the Molina members with the most open gaps on the schedule and seen by their assigned provider.
• Collaborates with Health Plan Community and Member Engagement resources to drive supporting effort on the member side.
• 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, electronic medical record (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 provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
• Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
• Collabor