Seattle, WA, USA
19 days ago
Senior Provider Engagement Specialist

***Remote and must live in Washington***

Job Description 
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. 
  Knowledge/Skills/Abilities 
The Senior Specialist, Provider Engagement contributes to one or more of these quality improvement functions: 
• 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. 
• 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 Qualifications



Required Education
Bachelor'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 Education
Preferred field: Clinical Quality, Public Health or Healthcare.
Preferred Experience
1 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.

 

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