Specialist, Member & Community Interventions (Remote in Kentucky)

Overview

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.

Responsibilities

• 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

Qualifications

REQUIRED QUALIFICATIONS :

PREFERRED QUALIFICATIONS :

Molina Healthcare is an Equal Opportunity Employer (EOE) M / F / D / V.

Pay Range : $47,433 - $92,494 / ANNUAL

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