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ATTENTION JOB SEEKERS AND MOLINA APPLICANTS: FRAUD ALERT

Be aware that third parties posing as Molina Healthcare may be soliciting money from job seekers and extending offers to candidates who have not interviewed. Molina does not engage in these type of practices. If you have received an offer and have not been engaging with Molina Healthcare in an interview process, reach out to erc@molinahealthcare.com to validate the legitimacy of your offer. Please note that Molina has reported this activity to the appropriate law enforcement agencies for further investigation. If you feel you’ve been victimized, please report it to local law enforcement.

Program Manager, Provider Engagement (Remote in MS only)

Molina Healthcare Jackson, Mississippi; Gulfport, Mississippi; Hattiesburg, Mississippi; Biloxi, Mississippi; Southaven, Mississippi; Mississippi Job ID 2028382
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***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

Pay Range: $59,810.6 - $129,589.63 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Type: Full Time Posting Date: 10/08/2024

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