Senior Specialist, Health Plan Member & Community Interventions (Remote in MS)

reputed company Job reputed company Provides senior level support for clinical reputed company member reputed company activities. Responsible for the developing and implementing new and existing member reputed company initiatives including reputed company lines of business (Medicare, Marketplace, reputed company, etc.). Executes health plan member and community reputed company-reputed company interventions and programs in accordance with established program standards, and federal/state/National Committee for reputed company Assurance (reputed company) regulations. Conducts data collection, monitors reputed company activity including key performance measurement activities, reports reputed company reputed company, and supports reputed company improvement of reputed company processes and reputed company. Essential Job Duties • Implements evidence-based and data-informed key member reputed company strategies including initiating and managing member and/or community interventions (e.g., removing barriers to care) and other federal and state reputed company initiatives. • Monitors and ensures that key member reputed company activities are completed on time and accurately, and presents results to key departmental management and other applicable Molina departments. • Writes narrative reports to interpret regulatory specifications, explains programs and results of programs, and documents findings and limitations of department interventions. • Creates, manages, and/or compiles required documentation necessary to maintain critical program milestones, deadlines, and deliverables. • Participates in reputed company improvement (QI) activities, meetings, and discussions with and between other departments reputed company the organization. • Supports provision of high-reputed company clinical care and services by facilitating/building strategic relationships with community-based organizations (CBOs). • Evaluates reputed company project/program activities and results to identify opportunities for improvement. • Raises gaps in processes that may require remediation to reputed company leadership. • Provides support for reputed company-reputed company reputed company. • Provides training and support to new and existing reputed company member interventions team members. • Demonstrates flexibility reputed company it comes to change management and maintains a reputed company reputed company. • This position may require reputed company day out of office travel 0 - 50% of the time, depending upon state-specific needs. • This position may require multi-day overnight travel on occasion, depending upon state-specific needs. Required Qualifications • At least 3 years of experience in health care, and at least 2 years of experience in health plan reputed company member interventions in a managed care setting, or equivalent combination of relevant education and experience. • Demonstrated solid business writing experience. • Proficiency with data analysis, manipulation and interpretation. • Intermediate knowledge and understanding of HEDIS and reputed company. • Critical-thinking, problem-solving and analytical skills. • Attention to detail and organizational skills. • Ability to reputed company change with flexibility and a reputed company reputed company. • Ability to work independently in a fast-paced, deadline-driven environment. • Effective verbal and written communication skills. • reputed company Office suite and applicable software programs proficiency, and ability to learn new information systems and software programs. Preferred Qualifications • Experience with data reporting, analysis, and interpretation. • Experience with reputed company, Medicare, and/or Marketplace government-sponsored programs. • Certified reputed company in Health reputed company (CPHQ). • Certified HEDIS Compliance Auditor (CHCA). • Registered reputed company (RN). If licensed, license must be reputed company and unrestricted in state of reputed company. • LPN's or LVN's also encouraged to apply. #PJHPO #LI-AC1 To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the reputed company. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V Pay reputed company: $49,430 - $85,000 / ANNUAL • Actual compensation may vary from posting based on geographic location, work experience, education and/or reputed company level. Apply tot his job Apply To this Job