Top 159 Implementation specialist Jobs in New Mexico

Senior Specialist, Health Plan Provider Engagement (Remote in NM)
Molina Healthcare —New Mexico
- $54,922 - $107,099 a year
- Full-time
- Nursing
- 3 years
- Analysis skills
- Health insurance
Registered Nurse (RN) Coordinator/Specialist
Memorial Medical Center —Las Cruces, NM
- Full-time
- Acute care
- Nursing
- RN License
- Disability insurance
- Relocation assistance
Quick Apply
Health Promotion Specialist (DOH/PHD#70204)
State of New Mexico —Albuquerque, NM
- $24.88 - $37.32 an hour
- Full-time
- Mid-level
- Office
- Driver's License
Benefits Specialist
University of New Mexico —Albuquerque, NM
- $3,844.53 - $5,399.33 a month
- Full-time
- Hybrid work
- Background check
- 6 years
- Research
- Health insurance
- Dental insurance
Indian Education Program Specialist (PED #21468)
State of New Mexico —Santa Fe, NM
- $36.43 - $54.65 an hour
- Full-time
- Mid-level
- Office
- Driver's License
Human Research Compliance & Quality Specialist
University of New Mexico —Albuquerque, NM
- $4,277.87 - $6,009.47 a month
- Full-time
- Background check
- Nursing
- 3 years
- Health insurance
- Dental insurance
Accreditation Specialist
Presbyterian Medical Services —Albuquerque, NM
- Full-time
- Nursing
- Customer service
- Mid-level
- Paid holidays
- Disability insurance
11d
Senior Training & Development Specialist (Learning Specialist 3)
Los Alamos National Laboratory —Los Alamos, NM
- $87,800 - $143,000 a year
- Email
- Laboratory
- Classroom
- 18 years or older
- Disability insurance
- Health insurance
10d
Community Health Promotion Specialist (DOH/PHD SW Region #11595)
State of New Mexico —Socorro, NM
- $24.88 - $37.32 an hour
- Full-time
- Mid-level
- Clinic
- Ability to lift 50 pounds
10d
Community Health Promotion Specialist (DOH/PHD SW Region #28417)
State of New Mexico —Alamogordo, NM
- $24.88 - $37.32 an hour
- Full-time
- Mid-level
- Clinic
- Ability to lift 50 pounds
10d
Program Specialist (BOSS)
University of New Mexico —Albuquerque, NM
- $3,882.67 - $5,453.07 a month
- Full-time
- Background check
- 6 years
- High school
- Health insurance
- Dental insurance
Records Management specialist NARA experience a plus (must have Federal Record Managment experience)
InfiniSource Consulting Solutions —New Mexico
- $90,000 - $100,000 a year
- Full-time
- Remote
- Customer service
- Office
- Supervising experience
- Disability insurance
- Health insurance
Quick Apply
Readiness Support Specialist (Operations Specialist 3/4)
Los Alamos National Laboratory —Los Alamos, NM
- $87,800 - $176,000 a year
- Email
- 18 years or older
- Microsoft Outlook
- 5 years
- Disability insurance
- Health insurance
Engagement Specialist
American Red Cross —Las Cruces, NM
- Full-time
- Microsoft Outlook
- Customer service
- Computer literacy
- Paid holidays
- Disability insurance
4d
Education Specialist- HSE Coordinator
University of New Mexico —Ranchos de Taos, NM
- $3,841.07 - $5,148.00 a month
- Full-time
- Background check
- Classroom
- 3 years
- Health insurance
- Dental insurance
Air & Ocean Specialist, Intermediate
Buckland —New Mexico
- Full-time
- Microsoft Outlook
- Mid-level
- High school diploma or GED
- Retirement plan
Quick Apply
Integrated Payload Project Team Specialist (Project/Program Specialist 1)
Los Alamos National Laboratory —Los Alamos, NM
- $72,800 - $115,400 a year
- Email
- Hybrid work
- 18 years or older
- Pass drug screening
- Mid-level
- Disability insurance
- Health insurance
Operations Specialist
University of New Mexico —Albuquerque, NM
- $3,802.93 - $5,097.73 a month
- Full-time
- Background check
- 7 years
- High school diploma or GED
- Health insurance
- Dental insurance
Program Specialist (C2C)
University of New Mexico —Albuquerque, NM
- $3,882.67 - $5,453.07 a month
- Full-time
- Background check
- 6 years
- High school
- Health insurance
- Dental insurance
Air & Ocean Specialist, Senior
Buckland —New Mexico
- Full-time
- Hybrid work
- Customer service
- Mid-level
- Microsoft Office
Quick Apply

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Senior Specialist, Health Plan Provider Engagement (Remote in NM)

Molina Healthcare -
New Mexico

Apply Now

Job Details

Full-time
$54,922 - $107,099 a year

Benefits

Health insurance

Qualifications

Optimizing workflow processes
Data visualization software proficiency
Medicare
Managed care
Managed care organization experience
Health insurance policy knowledge
Data reporting
Employee relationship building
Metrics Reporting
Change management
Quality performance measurement
Business intelligence tools
Clinical performance metrics
Medicaid
Productivity software
Clinical data analysis
Healthcare performance metrics analysis
Healthcare data reporting
Cross-functional communication
HEDIS
Data analysis software

Full 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, facilitates 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 75% 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.
*

#PJHPO

#LI-AC1

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $54,922 - $107,099 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply Now

Refine Your Search

implementation specialist jobs in new mexico

Senior Specialist, Health Plan Provider Engagement (Remote in NM)

Registered Nurse (RN) Coordinator/Specialist

Health Promotion Specialist (DOH/PHD#70204)

Benefits Specialist

Indian Education Program Specialist (PED #21468)

Human Research Compliance & Quality Specialist

Accreditation Specialist

Senior Training & Development Specialist (Learning Specialist 3)

Community Health Promotion Specialist (DOH/PHD SW Region #11595)

Community Health Promotion Specialist (DOH/PHD SW Region #28417)

Program Specialist (BOSS)

Records Management specialist NARA experience a plus (must have Federal Record Managment experience)

Readiness Support Specialist (Operations Specialist 3/4)

Engagement Specialist

Education Specialist- HSE Coordinator

Air & Ocean Specialist, Intermediate

Integrated Payload Project Team Specialist (Project/Program Specialist 1)

Operations Specialist

Program Specialist (C2C)

Air & Ocean Specialist, Senior

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