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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.

Specialist, Member & Community Interventions (Remote in Kentucky)

Passport Health Plan by Molina Healthcare

Owensboro, Kentucky; Covington, Kentucky; Louisville, Kentucky; Lexington-Fayette, Kentucky; Bowling Green, Kentucky

Job ID 2033254
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Overview

Passport Health Plan by Molina Healthcare has a mission to provide quality health care to those who need it, no matter their circumstances. Today, Molina health plans serve 3,331,000 members across the country through government-funded programs. Each day, we work to earn the trust our partners and members put in us, so they can lean on Molina. Together, Passport Health Plan and Molina share a commitment to improving the health and quality of life of our members across the Commonwealth of Kentucky.

Experienced professionals and new grads are encouraged to apply.
  • Full Time
  • Level: Mid-Level
  • Travel: Yes
  • Glassdoor Reviews and Company Rating

Success Profile

What makes you successful at Passport Health Plan by Molina Healthcare? Check out the traits we’re looking for and see if you're the right fit!

  • Compassionate
  • Consultive
  • Patient
  • Problem-Solver
  • Sincere
  • Relationship Expertise

BENEFITS

  • Insurance

    Medical · Dental · Vision Group & Voluntary Life Insurance Aflac · Pet Health · Identity Theft Auto & Home Insurance

  • Savings

    Flexible Spending Accounts 401K · Roth 401K Employee Stock Purchase Plan

  • Career Growth

    Continuing Education Units Education Reimbursement

  • Time Off

    Paid Time Off Volunteer Time Off Company Holidays

  • Additional Benefits

    Legal Assistance Plan Employee Assistance & Well Being Programs Employee Perks Platform Rideshare Portal

RESPONSIBILITIES

Job Description

Job Summary

The Specialist, Member & Community Interventions implements new and existing clinical quality member intervention initiatives including all lines of business (Medicare, Marketplace, Medicaid) Executes health plan’s member and community quality focused interventions and programs in accordance with prescribed program standards, conducts data collection, monitors intervention activity including key performance measurement activities, reports intervention outcomes, and supports continuous improvement of intervention processes and outcomes.

Job Duties

  • Implements evidence-based and data-informed key member intervention strategies, which may include initiating and managing member and/or community interventions (e.g., removing barriers to care) and other federal and state-required quality activities
  • Monitors and ensures that key member intervention activities are completed on time and accurately to present results to key departmental management and other Molina departments as needed
  • Writes narrative reports to interpret regulatory specifications, explain programs and results of programs, and document findings and limitations of department interventions
  • Creates, manages, and/or compiles the required documentation to maintain critical program milestones, deadlines, and/or deliverables
  • Participates in quality improvement activities, meetings, and discussions with and between other departments within the organization
  • Supports provision of high-quality clinical care and services by facilitating/building strategic relationships with community-based organizations
  • Evaluates project/program activities and results to identify opportunities for improvement
  • Surfaces to the Manager and Director any gaps in processes that may require remediation
  • Demonstrates flexibility when it comes to changes and maintains a positive outlook
  • Other tasks, duties, projects, and programs as assigned
  • This position may require same-day out-of-office travel 0 - 80% of the time, depending upon location
  • This position may require multiple days out-of-town overnight travel on occasion, 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 1-year experience in health plan quality member interventions, managed care, or equivalent experience
  • Demonstrated solid business writing experience
  • Operational knowledge and experience with Excel and Visio (flow chart equivalent)
  • Excellent problem-solving skills

PREFERRED QUALIFICATIONS:

  • Bachelor’s Degree in preferred field: Nursing, Social Work, Clinical Quality, Public Health, or Healthcare Administration
  • 1 year of experience in Medicare and in Medicaid managed care
  • Certified Professional in Health Quality (CPHQ)
  • Nursing License (RN may be preferred for specific roles)
  • Certified HEDIS Compliance Auditor (CHCA)

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: $47,433 - $92,494 / 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 09/05/2025

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