Transformational Leader: Specialist, Provider Quality & Practice Transformation

Join Our Mission to Revolutionize Healthcare Quality at Molina Healthcare, where we're dedicated to improving the lives of our members. We're seeking a highly skilled and passionate Specialist, Provider Quality & Practice Transformation to join our team in a Remote capacity. As a key member of our Quality Improvement function, you will play a vital role in driving success and making a meaningful impact on the lives of our members.

In this critical position, you will be responsible for overseeing, planning, and implementing new and existing healthcare quality improvement initiatives and education programs specific to our Provider Network. You will ensure the maintenance of Provider Quality Improvement programs in accordance with prescribed quality standards, conduct data collection, reporting, and monitoring for key performance measurement activities, and drive the development of key quality and population health strategies.

Job Summary

The Specialist, Provider Quality & Practice Transformation will contribute to the development and implementation of quality improvement and risk adjustment initiatives, working closely with providers, Health Plan Leadership, and other stakeholders to engage and empower members and impact health outcomes. This role requires a strong foundation in Quality/HEDIS, as well as excellent analytical, communication, and project management skills.

Key Responsibilities

• Implement key quality and population health strategies and risk adjustment initiatives to drive improved health outcomes and member engagement
• Collaborate with providers to identify areas of need and develop efficiency measures to improve availability and quality of care
• Coach practices on quality improvement and value-based purchasing goals, and assess provider readiness for higher levels of value-based purchasing
• Facilitate provider engagement meetings, monitor action items, and ensure timely completion of key quality activities
• Create, manage, and compile required documentation to maintain critical quality improvement and risk adjustment functions
• Evaluate project and program activities to identify opportunities for improvement and surface gaps in processes that require remediation

Requirements

To be successful in this role, you will need:

• Bachelor's Degree or equivalent combination of education and work experience
• Minimum 3 years' experience in healthcare, with 1 year of experience in health plan quality improvement, risk adjustment, or managed care
• Demonstrated solid business writing experience and operational knowledge of Excel and Visio (or equivalent)
• Preferred experience in Medicare and Medicaid, as well as certifications such as CPHQ or RN licensure

What We Offer

Molina Healthcare offers a competitive benefits and compensation package, as well as opportunities for professional growth and development. We are an Equal Opportunity Employer (EOE) M/F/D/V, and we welcome applications from talented candidates like you.

Are You the One We're Looking For?

If you're passionate about improving healthcare quality and have the skills and experience to make a real difference, we encourage you to apply for this exciting opportunity. Apply now and join our team of dedicated professionals who are committed to transforming the healthcare landscape.