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HomeCompaniesHckd Fa Us2 Oraclecloud Com CX 1Senior Specialist, Provider Engagement (Must reside in Idaho)

Senior Specialist, Provider Engagement (Must reside in Idaho)

Hckd Fa Us2 Oraclecloud Com CX 1 · UT, United States; Remote Employees, Long Beach, CA, US · Remote · Active · Oracle Recruiting Cloud / Fusion HCM

Job facts

FieldValue
CompanyHckd Fa Us2 Oraclecloud Com CX 1
TitleSenior Specialist, Provider Engagement (Must reside in Idaho)
Normalized title-
Department / teamQuality & Risk Adjustment
LocationUT, United States
Work modelRemote / Remote
Employment typeFull Time
Salary-
Statusactive
ATS providerOracle Recruiting Cloud / Fusion HCM
Posted / first seen2026-03-30 / 2026-05-31
Changed / last seen2026-06-03 / 2026-06-06

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Department jobsActive postings in Quality & Risk Adjustment.Open
Work model jobsActive Remote postings.Open
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Original postingCanonical source or apply URL captured from the ATS.Open

Linked records

CompanyHckd Fa Us2 Oraclecloud Com CX 1
Source8214b818-efda-4f30-9713-cac0e888e0f9
ATS providerOracle Recruiting Cloud / Fusion HCM

Description

Description Job Description Job Summary Provides senior level support for implementation of health plan provider engagement strategies and activities to drive necessary quality and risk adjustment outcomes Uses a consultative approach emphasizing physician engagement and behavior change through actionable data and analytics. Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures assigned Tier 1 & Tier 2 providers have engagement plans ensuring they 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, facilitate data exchanges, and supports training and problem resolution for assigned providers - driving provider participation in Molina's risk adjustment and quality initiatives. ESSENTIAL JOB DUTIES: Provides support for provider engagement activities including enhancing value-based strategies, and risk adjustment/quality improvement initiatives. 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. Drives provider partner coaching and collaboration to improve Medicaid, Medicare and Marketplace quality performance and risk adjustment accuracy through consistent provider meetings, action item development and execution. Works with provider front-office staff to get the Molina members with the most open gaps on the schedule and seen by their assigned provider. 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. Drives provider participation in Molina risk adjustment and quality efforts (e.g. supplemental data, electronic medical record (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 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. Accountable for use of standard Molina Provider Engagement reports and training materials. 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. Provides training and support for new and existing practice transformation and provider engagement team members. Maintains the highest level of compliance. May require same day out-of-office travel up to 80% of the time, depending upon state/health plan requirements. REQUIRED QUALIFICATIONS: At least 3 years of experience improving population-level HEDIS quality scores and burden of illness documentation accuracy through provider engagement, or equivalent combination of relevant education and experience. Experience with various managed health care provider compensation methodologies including but not limited to: fee-for service (FFS), value-based care (VBC), and capitation. 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. Critical-thinking, problem-solving and analytical skills. Relationship building skills. Attention to detail and organizational skills. Ability to implement process improvement initiatives and drive change. Ability to work independently in a fast-paced, deadline-driven environment. Ability to foster and build relationships in a cross-functional highly matrixed organization to obtain buy-in and drive results Effective verbal and written communication skills. Microsoft Office suite (including Excel), Power BI, and other applicable software programs proficiency, and ability to learn new information systems and software programs. PREFERRED QUALIFICATIONS: Bachelor’s degree in Nursing, Health Administration or relevant discipline. Solid understanding of health insurance, provider messaging/design and project management. 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 intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Full job record

Job ID5cf2c57ea54ff2c84243cbf4ec94a172b5ab0a5f
Org ID6fcfe228-ec8c-4e31-bf8d-2e5d2cb49f0a
Source ID8214b818-efda-4f30-9713-cac0e888e0f9
Board ID8214b818-efda-4f30-9713-cac0e888e0f9
Provideroracle_hcm
Provider Job Key2036569
TitleSenior Specialist, Provider Engagement (Must reside in Idaho)
Normalized Title
Statusactive
Activeyes
Location TextUT, United States; Remote Employees, Long Beach, CA, US
DepartmentQuality & Risk Adjustment
Team
Employment Typefull_time
Workplace Typeremote
Remote Policyremote
CountryUnited States
RegionUT
City
Salary RawDescription Job Description Job Summary Provides senior level support for implementation of health plan provider engagement strategies and activities to drive necessary quality and risk adjustment outcomes Uses a consultative approach emphasizing physician engagement and behavior change through actionable data and analytics. Drives value-based care strategies through risk adjustment and quality improvement activities. Ensures assigned Tier 1 & Tier 2 providers have engagement plans ensuring they 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, facilitate data exchanges, and supports training and problem resolution for assigned providers - driving provider participation in Molina's risk adjustment and quality initiatives. ESSENTIAL JOB DUTIES: Provides support for provider engagement activities including enhancing value-based strategies, and risk adjustment/quality improvement initiatives. 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. Drives provider partner coaching and collaboration to improve Medicaid, Medicare and Marketplace quality performance and risk adjustment accuracy through consistent provider meetings, action item development and execution. Works with provider front-office staff to get the Molina members with the most open gaps on the schedule and seen by their assigned provider. 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. Drives provider participation in Molina risk adjustment and quality efforts (e.g. supplemental data, electronic medical record (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 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. Accountable for use of standard Molina Provider Engagement reports and training materials. 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. Provides training and support for new and existing practice transformation and provider engagement team members. Maintains the highest level of compliance. May require same day out-of-office travel up to 80% of the time, depending upon state/health plan requirements. REQUIRED QUALIFICATIONS: At least 3 years of experience improving population-level HEDIS quality scores and burden of illness documentation accuracy through provider engagement, or equivalent combination of relevant education and experience. Experience with various managed health care provider compensation methodologies including but not limited to: fee-for service (FFS), value-based care (VBC), and capitation. 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. Critical-thinking, problem-solving and analytical skills. Relationship building skills. Attention to detail and organizational skills. Ability to implement process improvement initiatives and drive change. Ability to work independently in a fast-paced, deadline-driven environment. Ability to foster and build relationships in a cross-functional highly matrixed organization to obtain buy-in and drive results Effective verbal and written communication skills. Microsoft Office suite (including Excel), Power BI, and other applicable software programs proficiency, and ability to learn new information systems and software programs. PREFERRED QUALIFICATIONS: Bachelor’s degree in Nursing, Health Administration or relevant discipline. Solid understanding of health insurance, provider messaging/design and project management. 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 intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Salary Min
Salary Max
Salary Currency
Salary Periodday
Source URLhttps://hckd.fa.us2.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_1/job/2036569
Apply URLhttps://hckd.fa.us2.oraclecloud.com/hcmUI/CandidateExperience/en/sites/CX_1/job/2036569
First Seen At2026-05-31 18:03:56Z
Last Seen At2026-06-06 11:30:43Z
Last Checked At2026-06-06 11:30:43Z
Last Changed At2026-06-03 11:24:46Z
Inactive At
Source Posted At2026-03-30 21:45:02Z
Source Updated At
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GET https://api.bluedoor.sh/job-postings/v1/jobs/5cf2c57ea54ff2c84243cbf4ec94a172b5ab0a5f?include=descriptionJSON
GET https://api.bluedoor.sh/job-postings/v1/orgs/6fcfe228-ec8c-4e31-bf8d-2e5d2cb49f0aJSON
GET https://api.bluedoor.sh/job-postings/v1/sources/8214b818-efda-4f30-9713-cac0e888e0f9JSON
GET https://api.bluedoor.sh/job-postings/v1/jobs/5cf2c57ea54ff2c84243cbf4ec94a172b5ab0a5f/eventsJSON