This position is responsible for guiding strategy and operational direction for provider engagement within Molina's Provider Engagement Center of Excellence. The role focuses on risk adjustment and quality improvement for assigned Health Plans, driving provider participation in Molina's programs, setting performance goals, and ensuring accurate tracking of engagement activities. The position requires collaboration with various departments, development of training materials, and maintaining compliance standards.
JOB DESCRIPTION
Job Summary
The Director, Provider Engagement role within Molina’s Provider Engagement Center of Excellence (CoE) will guide strategy and operational direction for engaging providers on risk adjustment and quality improvement for assigned Health Plans. It will drive increased provider participation in Molina's risk adjustment and quality programs, set and monitor performance goals, and ensure accurate tracking of engagement activities. Additionally, this role will function as a subject matter expert, collaborating with various departments to develop training materials and maintain the highest level of compliance.
KNOWLEDGE/SKILLS/ABILITIES
- Guides strategy and operational direction for engaging providers on risk adjustment and quality improvement for assigned Health Plans.
- Drives increased 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 for assigned Health Plans.
- Sets, monitors, and drives success on Provider performance goals for Provider Engagement KPIs and oversees Provider-level execution plans to meet committed goals for each assigned Health Plan.
- Drives increased Risk & Quality focused Value-Based Contracts for assigned Health Plans.
- Ensures accurate tracking of all Provider Engagement and Training activities on a monthly basis for assigned Health Plans.
- Acts as a Provider Engagement subject matter expert; works collaboratively with Molina’s Health Plans, Centers of Excellence, and Shared Services to drive improved risk adjustment and quality of care.
- Assesses team member competencies across required competency matrix and ensures they receive needed training on any lagging competencies.
- Collaborates with Molina Provider Engagement CoE team members to develop and deploy Health Plan training materials.
- Works with various departments within Molina’s Risk & Quality organization to ensure connected efforts and consistent messaging to assigned Health Plans.
- Ensures the use of standard reports and training materials by the assigned Health Plan Provider Engagement team.
- Communicates effectively with all levels of a healthcare organization, within both corporate and regional market environments, and with external provider partners.
- Maintains the highest level of compliance.
- This position may require out of office travel approximately 10% of the time.
JOB QUALIFICATIONS
Required Qualifications:
• Bachelor's Degree in a related field or equivalent combination of education and experience
• At least 7 years’ experience in healthcare, with a focus on Risk & Quality improvement and driving performance across a large, matrixed organization.
Preferred Qualifications
Experienced driving improved Physician Risk & Quality performance through Value Based Contracts
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: $97,299 - $150,000 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
