- 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.
- 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).
- Certified Professional in Health Quality (CPHQ)
- Nursing License (RN may be preferred for specific roles)
- Certified HEDIS Compliance Auditor (CHCA)
-
Sr. Specialist, Provider Engagement- Quality
2 weeks ago
Molina Healthcare Phoenix, United States**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 ...
-
Sr. Specialist, Provider Engagement- Quality
3 weeks ago
Molina Healthcare Gilbert, AZ, United StatesJob 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 ...
-
Sr. Specialist, Provider Engagement- Quality
3 weeks ago
Molina Healthcare Gilbert, United StatesJob 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 ...
-
Director of Volunteer Engagement
2 weeks ago
St Vincent De Paul Phoenix, United States**Job Title**: Director of Volunteer Engagement · **Department**: 303 Volunteer Engagement (VE) · **Reports To**: Chief Engagement Officer · **FLSA Status**: Exempt · **Safety Sensitive: N**o · **Job Summary**: · The Director of Volunteer Engagement is both strategic and operatio ...
-
Retail & Community Engagement Manager
1 week ago
Kneaders Phoenix, United States**Work-Life balance** - all **Kneaders Bakery & Cafe** locations are closed every Sunday & are closed on Thanksgiving Day & Christmas every year. · - **Free meal** provided during each shift worked as well as generous food & retail discounts provided too. · - **Health benefits** ...
-
Volunteer Engagement Coordinator
2 weeks ago
St Vincent De Paul Phoenix, United States**Job Title**:Volunteer Engagement Coordinator · **Department**: 303 Volunteer Engagement · **Reports To**: Director of Volunteer Engagement · **FLSA Status**: Exempt · **Safety Sensitive: N**o · **Job Summary**: · To ensure an excellent volunteer experience, providing the necess ...
-
Provider Liaison Specialist
3 weeks ago
Infusion4Health Inc Phoenix, United StatesInfusion For Health is a private-equity-backed healthcare provider expanding throughout California, Arizona, Washington, Colorado, Nevada, and Missouri. Infusion For Health is focused exclusively on infusion therapies for chronic conditions, such as multiple sclerosis, inflammato ...
-
Volunteer Engagement Specialist
2 weeks ago
St Vincent De Paul Phoenix, United States**Job Title**: Volunteer Engagement Specialist · **Department**: 303 Volunteer Engagement · **Reports To**: Director of Volunteer Engagement · **FLSA Status**: Non-Exempt · **Safety Sensitive**: No · **Job Summary**: · The Society of St. Vincent de Paul is committed to serving th ...
-
Security - Client Navigator
2 weeks ago
Community Medical Services Phoenix, United StatesOverview: · **Shift: 4:30AM-12:30PM Monday - Friday, rotating Saturdays 6AM-9AM** · Community Medical Services (CMS) is now hiring a Client Navigator to promote a positive, safe, and secure recovery environment for patients recovering from addictions to opioids and other illicit ...
-
Director of Provider Relations and Value-based
2 weeks ago
tango Phoenix, United StatesWe're looking for a dynamic, self-motivated leader to join us as our Director of Provider Relations and Value-Based Performance. In this crucial role, you'll oversee markets where we support value-based home health management. Your main responsibilities will include forging and n ...
-
Retail Solar Associate
2 weeks ago
Sunsolar Solutions Inc Phoenix, United StatesSunSolar Solutions, Arizona's largest best-rated solar sales and installation company, is currently seeking enthusiastic and motivated individuals to join our team as Retail Solar Associate. We have exciting opportunities for 12 positions in our sales department, catering to both ...
-
Justice Involved Case Manager/bht
3 weeks ago
AZ Center for Change Phoenix, United States**Summary**: · AZCFC has a 18 year proven track record for excellence in providing evidence based services to justice involved individuals as well as behavioral health services. We are seeking passionate and motivated individuals to provide case management and direct services to ...
-
Beneficiary Engagement Specialist
2 weeks ago
VBCare Network LLC Phoenix, United States**Overview** · The purpose of this position is to support the ABC and VBCare Network Medicare and Medicaid engagement and relationship building programs, manage and address member inquiries, complaints, make outreach calls, request for information from health centers, as necessar ...
-
LOFTY INC. Phoenix, United States: · LoftyWorks is a comprehensive prop-tech software solution that simplifies property management through various tools, including CRM automation and customer communication. It facilitates efficient operations, property portfolio management, and offers top-tier financial manageme ...
-
Client Engagement Specialist
3 weeks ago
Human Services Campus, Inc. Phoenix, United States**Summary**: · The Engagement Specialist reports directly to the Supportive Services Supervisor/ Manager. This position will provide direct service to individuals whom utilize the Human Services Campus mail room by way of purposeful engagement to provide needed service and seek s ...
-
Retail Sales Associate Full Time or Part Time
3 weeks ago
Castle Megastore Phoenix, United States**Immediately hiring for part time positions** · **Starting at $17.00-$18.00 per hour depending on availability/location and previous work experience** · **Excellent growth and advancement opportunities** · **Who We Are**: · Celebrating more than 35 years, Castle Megastore has be ...
-
Registered Sleep Technician
2 weeks ago
NeuroDiagnostic Laboratories and Sleep Centers Phoenix, United States**About** · NeuroDiagnostic Laboratories changes the patient experience. We strive to make it easier and faster for patients to get their needed testing, understand their results, and get the follow-up treatment that they need for improved health. · **Position Summary** · The Sle ...
-
Associate Dentist
3 weeks ago
Arizona Special Needs Clinic Phoenix, United States: · Overview: · **Responsibilities**: · - Provide high-quality dental care to patients with special needs, adapting to their unique requirements and ensuring a compassionate and practical treatment experience. · - Collaborate with a team of dedicated dental professionals within t ...
-
ImageNetLLC Phoenix, United States**$500 HIRING BONUS AFTER 90 DAYS OF **SUCCESSFUL** EMPLOYMENT** · **MUST BE LOCAL TO PHOENIX** · This position is based in our Phoenix office. However, employees who consistently meet performance metrics are eligible for a flexible work arrangement that allows working from home. ...
-
Service Representative
2 weeks ago
Event Network Phoenix, United States Part timeDo you have retail store experience, does Arizona's proud cultural heritage and welcoming resort destinations connect to your interests, and do you want to work for an amazing company that puts its Team, Partners, Guests & Planet first? · Be a part of this premier luxury resort a ...
Sr. Specialist, Provider Engagement - Phoenix, United States - Molina Healthcare
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.
You will need Quality / HEDIS, Provider Engagement and Health plan experience for this position.
Knowledge/Skills/Abilities:
The Senior Specialist, Provider Engagement contributes to one or more of these quality improvement functions:
Job Qualifications
Required Education
Bachelor's Degree or equivalent combination of education and work experience.
Required Experience
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
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, $97,362.61 a year**Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Pay Range:
$44, $97,362.61 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.