Molina Healthcare
Senior Specialist, Health Plan Provider Engagement (Remote in KY)
Louisville, KY, United States · Senior
Sponsorship not specifiedDetected 1 day ago
Data AnalysisData VisualizationExcelProcess ImprovementEHR/EMRCommunicationCollaborationProblem SolvingMentoringMicrosoft Office
Stay score
odds of building a lasting career here
31Risky
Cap-exempt (no lottery)0
Sponsors this role58
Entry-level history0
PERM / green-card track0
Lottery odds40
Fits your clock70
Thin sponsorship signal and lottery-bound. A low-probability bet with your clock running. Prioritize cap-exempt roles and proven entry-level sponsors first.
Lottery odds assume a STEM candidate.
Personalize to your clock →Employer immigration record
from this employer's Department of Labor filings
Green-card filing pattern in this occupation
Context, not a finding about this posting: of this employer's 7 green-card filings in this occupation, 100% were for a worker who already held the job.
Green-card follow-through: 40%
Of 5 labor certifications old enough to have been used, 3 expired without the employer filing the next step. Median time from filing to decision: 500 days.100% of their filings were for a worker who already held the job.Only certifications past the 180-day window are counted — recent ones cannot have expired yet.
Files H-1B transfers
2 transfer filings in the last year, covering 2 workers. Median labor-condition decision: 8 days. An employer that already files transfers is one that can take over an existing H-1B.
Sourced from Department of Labor LCA, PERM and prevailing-wage disclosure data. Employer matching is by name, so figures may be split across an employer's legal entities. Absence of a filing means none appears in our copy of the data, not that none exists.
Community outcomes
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About the role
- Ensures assigned Tier 1 & Tier 2 providers have engagement plans ensuring they meet annual quality and risk adjustment goals.
- Addresses practice environment challenges to achieve program goals and improve health outcomes.
- Ensures assigned Tier 1, Tier 2, and where applicable Tier 3, providers have a provider engagement plan to meet annual quality and risk adjustment performance goals.
Responsibilities
- Provides support for provider engagement activities including enhancing value-based strategies, and risk adjustment/quality improvement initiatives.
- Provides training and support for new and existing practice transformation and provider engagement team members.
- Maintains the highest level of compliance.
Requirements
- Working knowledge of quality metrics and risk adjustment practices across all business lines.
- Knowledge and understanding of HEDIS/NCQA and/or CMS STARs quality measures and risk adjustment practices across Medicaid, Medicare and Marketplace.
- Proficiency with data analysis, manipulation, interpretation and reporting.
- Ability to work independently in a fast-paced, deadline-driven environment.
- Microsoft Office suite (including Excel), Power BI, and other applicable software programs proficiency, and ability to learn new information systems and software programs.
Nice to have
- Strong experience using Microsoft products, including Excel (knowledge of pivot tables, VLOOKUP, etc.) and PowerPoint.
- To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Compensation
- Ensures assigned Tier 1, Tier 2, and where applicable Tier 3, providers have a provider engagement plan to meet annual quality and risk adjustment performance goals.
Benefits
- Coordinates with Health Plan Community and Member Engagement resources to drive supporting effort on the member side.
- Addresses challenges/barriers in the practice environment impeding successful attainment of program goals and understands solutions required to improve health outcomes.
- Tracks all engagement and training activities using standard Molina provider engagement tools to measure effectiveness both within and across Molina health plans.
- Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals.
- Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues.
- Develops, organizes, analyzes, documents and implements processes and procedures as prescribed by health plan and corporate policies.
- Communicates comfortably and effectively with internal and external stakeholders, including physician leaders, providers, practice managers, and medical assistants within assigned provider practices.
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This listing is sourced directly from Molina Healthcare's careers page and normalized into a canonical job model.