Program Manager, Provider Engagement (Remote in MS only)
? **Remote and must live in Mississippi***
Job Description...
Job Summary
The Program Manager, Provider Engagement is part of our innovative Risk Adjustment department to assist our diverse team of data leaders, risk adjustment experts, and developers in the development and implementation of business strategies, operations and vendor management related to provider engagement activities in all government lines of business impacted by the regulatory risk adjustment payment model.
They will be accountable for implementing and managing the prospective provider engagement programs that lead to the overall achievement of improved risk score accuracy, compliancy and completeness in risk adjustment revenue for all government lines of business to better support overall population heath management, reduce gaps in care and drive medical loss ratio (MLR) targets. In conjunction with the Director of Prospective Programs, this role supports the strategic direction and organization of corporate initiatives to facilitate achievement of the provider engagement programs.
Knowledge/Skills/Abilities
This role interacts and supports regulatory agency policy and procedures by acting as a key business partner to the Director, Prospective Programs, Market & Segment Leaders, provider network team, health plan teams, external vendors, actuary, and finance. Direct reports to the Manager include program specialist.
The position's essential functions are as follows:
Collaborates with colleagues to implement and manage provider engagement program initiatives such as provider education/engagement and provider incentives.
Collaborates with contracted vendors and colleagues to develop and implement provider education/engagement in risk adjustment models to better align with clinical documentation requirements, value-based payment programs and/or provider performance programs.
Responsible for tracking and monitoring success of provider engagement program initiatives against set goals, develops corrective action plans for program and partnering vendors, communicates program progress.
Responsible for communicating provider engagement activities to key stakeholders such as provider network teams and health plan teams.
Develops and maintains program work plans, workflows, and related program documentation.
Maintains compliance with all policies and procedures.
Adheres to all confidentiality and HIPAA requirements as outlined within Policies and Procedures in all ways and at all times with respect to any aspect of the data handles or services rendered in the undertaking of the position.
Fulfills those responsibilities and/or duties that may be reasonably provided by Molina for the purpose of achieving operational and financial success of the Company..
Job Qualifications
Required Education
Minimum Bachelor's Degree in Public Health, Business, Finance or equivalent combination of education and experience
Required Experience
3-5 years managed care experience, preferably with a national or multi-location organization
Experience in a complex healthcare delivery environment, specifically with government sponsored programs, including risk revenue management, strategy and compliancy
Proven ability to innovate and drive organizational change
Excellent presentation and communication skills
Preferred Education
Graduate Degree preferred
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
Similar Remote Jobs
Program Manager, Provider Engagement (Remote in MS only)
Posted on: 13-11-2024 04:55
Exciting Opportunity: Kelly Data Entry Jobs Available Now
Posted on: 13-11-2024 04:55
Exciting Part Time Job from Home Office Opportunity
Posted on: 13-11-2024 04:55
Remote Production Operations Coordinator I Bristol, CT, USA
Posted on: 13-11-2024 04:55
Marketing Strategy Manager- Water Parks Celebration, FL, USA
Posted on: 13-11-2024 04:55
Exciting Opportunities for Flexible Jobs Under 16 Hours!
Posted on: 13-11-2024 04:55
Transitions Director | Portfolio Administration | Fully Remote
Posted on: 13-11-2024 04:55
Strategic Foresight Manager, Global Security and Resilience Services
Posted on: 13-11-2024 04:55
Technical Support Professional Software Engineer Poughkeepsie, New Yor
Posted on: 13-11-2024 04:55
Join Insight Global ? Remote Job Opportunities Await!
Posted on: 13-11-2024 04:55
Senior Analyst - Crew Staffing (Remote Work Assignment Available)
Posted on: 20-01-2025 06:21
TikTok Ads Specialist
Posted on: 16-07-2024 18:58
Associate Counsel (Remote)
Posted on: 22-10-2024 05:25
3 month REMOTE -Digital Content Developer $30-$32hr
Posted on: 26-08-2024 00:00
Entry-Level Benefits Sales Manager - Work Remotely with Flexibility
Posted on: 20-01-2025 06:21
Sr. Decision Scientist / Business Analytics - Clinical Analytics (Remote)
Posted on: 09-11-2024 04:38
Pharmacy Technician, Clinical Customer Care - Work From Home
Posted on: 27-08-2024 00:00
Parcel Delivery Specialist
Posted on: 26-09-2024 00:00
Live chat specialist (REMOTE)
Posted on: 20-08-2024 00:00
Customer Service Representative - 100% Remote Texas
Posted on: 15-09-2024 00:00