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Sr. Specialist, Provider Engagement- Quality / HEDIS (Remote in AZ) - Tucson Arizona
Company: Molina Healthcare Location: Tucson, Arizona
Posted On: 05/08/2024
Job Summary Molina'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/Abilities The 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 assigned.. - Job 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 year* *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. #PJCorp #LI-AC1 Pay Range: $44,936.59 - $97,362.61 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. More...
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