Manager, Provider Quality & Practice Transformation (Remote IA)
Company: Molina Healthcare
Location: Iowa City
Posted on: January 23, 2023
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.
- 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
- Participates in state level quality and risk adjustment
strategy meetings, develops a quality workplan, and ensures
integration of quality and risk adjustment into the overall
- 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
- 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
- Project management experience, in a managed healthcare
- 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. - Pay Range: -$66,456.22 - $129,589.63 a
year* *Actual compensation may vary from posting based on
geographic location, work experience, education and/or skill level.
Keywords: Molina Healthcare, Iowa City , Manager, Provider Quality & Practice Transformation (Remote IA), Executive , Iowa City, Iowa
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