Manager Provider Quality and Practice Transformation- Remote in NV

Molina Healthcare
US - Nevada - Reno
June 27, 2024

*JOB DESCRIPTION
• Job Summary
• Responsible for continuous quality improvements and risk adjustment accuracy for all government lines of business. Supports robust provider engagement to achieve positive operational and financial outcomes.
• Candidates must have experience in healthcare quality interventions and provider partnership for this position.
• KNOWLEDGE/SKILLS/ABILITIES
• + Establishes the strategy and operational direction for provider engagement and practice transformation, in collaboration with the Plan President, network and operations staff for larger value based contracted provider organizations.
• Provides strategic direction for provider quality and practice transformation specialists to help providers understand how to improve quality and progression toward meeting value-based purchasing goals and assesses provider readiness for higher levels on the value-based purchasing continuum.
• Ensures health plan provider engagement stakeholders are engaged and prepared to report quarterly updates at the meetings and overall, to health plan Senior Leadership Team meetings.
• Leads one or more teams from multiple disciplines (Quality, Provider Services, Clinical, Operations) to engage with key providers.
• Has overall responsibility for the content, maintenance and access to the Health Plan provider quality and practice transformation SharePoint site.
• Builds internal relationships to develop a team approach to provider engagement.
• Builds and nurture positive relationships between strategic providers and Plan.
• Reports on strategic provider results (e.g., changes in quality outcomes, financial results, etc.) on periodic basis to Senior Leadership Team.
• JOB QUALIFICATIONS
• Required Education:
• Bachelor's Degree or equivalent combination of education and experience.
• Required Experience:
• + Min 5 years' experience in managed healthcare administration and/or Provider Services.
• Provider contract network development & management experience
• Project management experience, in a managed healthcare setting
• Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid, Marketplace and Medicare lines of business, including but not limited to fee-for service, capitation and various forms of risk, ASO, etc.
• Preferred Education:
• Master's Degree
• Preferred Experience:
• + Experience with risk adjustment and quality metrics with government business lines of business.
• Previous provider relationship and engagement preferred
• Experience with Value Based Contract arrangements, and provider engagement
• Preferred License, Certification, Association:
• RN license
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.
\#PJCorp
\#LI-AC1
Pay Range: $69,779 - $136,069 / ANNUAL
• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Read the full job description and apply online on the recuiter's web-site

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