Specialist, Provider Engagement (Remote in TX) – USA Remote Jobs

Remote, USA Full-time
September 20, 2025 Job Summary The Provider Engagement Specialist, role implements Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. Ensures the smaller, less advanced Tier 2 and Tier 3 providers have engagement plans to meet annual quality and risk adjustment goals. Drives coaching and collaboration with providers to improve performance through regular meetings and action plans. Addresses practice environment challenges to achieve program goals and improve health outcomes. Tracks engagement activities using standard tools, facilitates data exchanges, and supports training and problem resolution for the Provider Engagement team. Communicates effectively with healthcare professionals and maintains compliance with policies. Job Duties Ensures assigned Tier 2 & Tier 3 providers have a Provider Engagement plan to meet annual quality & risk adjustment performance goals. Drives provider partner coaching and collaboration to improve quality performance and risk adjustment accuracy through consistent provider meetings, action item development and execution. Addresses challenges/barriers in the practice environment impeding successful attainment of program goals and understands solutions required to improve health outcomes. Drives provider participation in Molina risk adjustment and quality efforts (e.g. Supplemental data, EMR connection, Clinical Profiles programs) and use of the Molina Provider Collaboration Portal. Tracks all engagement and training activities using standard Molina Provider Engagement tools to measure effectiveness both within and across Molina Health Plans. Serves as a Provider Engagement subject matter expert; works collaboratively within the Health Plan and with shared service partners to ensure alignment to business goals. Accountable for use of standard Molina Provider Engagement reports and training materials. Facilitates connectivity to internal partners to support appropriate data exchanges, documentation education and patient engagement activities. Develops, organizes, analyzes, documents and implements processes and procedures as prescribed by Plan and Corporate policies. Communicates comfortably and effectively with Physician Leaders, Providers, Practice Managers, Medical Assistants within assigned provider practices. Maintains the highest level of compliance. This position may require same day out of office travel approximately 0 - 80% of the time, depending upon location. JOB QUALIFICATIONS REQUIRED QUALIFICATIONS: Associate’s degree or equivalent combination of education and work experience. 1-3 years experience in healthcare with minimum 1 year experience improving provider Quality performance through provider engagement, practice transformation, managed care quality improvement, or equivalent experience. Working knowledge of Quality metrics and risk adjustment practices across all business lines Demonstrates data analytic skills Operational knowledge and experience with PowerPoint, Excel, Visio Effective communication skills Strong leadership skills" 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: $45,390 - $88,511.46 / ANNUAL Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Apply Now

Similar Jobs

Senior Inpatient Medical Coder - National Remote – USA Remote Jobs

Remote, USA Full-time

Care Admin Specialist (Part-Time) – USA Remote Jobs

Remote, USA Full-time

Care Admin Specialist (Part-Time) – USA Remote Jobs

Remote, USA Full-time

Hybrid Clinical Reviewer II - PASRR (Southeast Region in MA) presso Un – USA Remote Jobs

Remote, USA Full-time

Clinical Reviewer II - Licensed /Remote in NM – USA Remote Jobs

Remote, USA Full-time

Remote Sr. Coding Specialist (Mental Health) – USA Remote Jobs

Remote, USA Full-time

Care Planner – Behavioral Health – USA Remote Jobs

Remote, USA Full-time

RN Care Coordinator - Remote in Archuleta, La Plata, Dolores and Monte – USA Remote Jobs

Remote, USA Full-time

Care Advocate Behavioral Health - San Diego Only--Remote – USA Remote Jobs

Remote, USA Full-time

Patient Relations Coordinator - Remote in Eugene, OR – USA Remote Jobs

Remote, USA Full-time

Part-Time Dental Assistant

Remote, USA Full-time

**Experienced Virtual Customer Care Representative – Delivering Exceptional Pet Parent Experiences at arenaflex**

Remote, USA Full-time

**Experienced Customer Care Representative – Join blithequark's Dynamic Team**

Remote, USA Full-time

Field Marketing Manager, Central

Remote, USA Full-time

Digital Marketing Manager – Strategic Ownership

Remote, USA Full-time

Specialist - Digital Marketing and Analytics

Remote, USA Full-time

Senior Specialist Contracts Administration (REMOTE)

Remote, USA Full-time

Experienced Remote Live Chat Support Agent - Customer Service Excellence at blithequark

Remote, USA Full-time

Craft Superintendent - Electrical Services

Remote, USA Full-time

**Experienced Full Stack Data Entry Specialist – Remote Work Opportunity for Students**

Remote, USA Full-time
Back to Home