Health Plan Provider Engagement Manager

Let’s do great things, together

Founded in Oregon in 1955, ODS, now Moda, is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together.

Job Summary:
Manages the Provider Engagement Liaisons, including the managing of activities and tasks related to initiatives aimed to improve the alignment of commercial and Medicare Advantage Quality, HEDIS, Medicare and Marketplace Stars, Risk Adjustment, commercial and Medicare Advantage VBC initiatives and performance guarantees by outreaching to clinics and providers within the Moda network.  Oversees the development of project work plans, including execution of project tasks and deliverables, gathering/defining/documenting of requirements, and reporting project status. Responsible for working closely with internal and external stakeholders in meeting expectations for achieving strategic objectives and tracking the return on investment (ROI) of the team.

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The salary range for this position is $74,334.50 - $95,000, DOE.

This is a Hybrid position. We are only offering this position to candidates living in or willing to relocate to OR or WA.

Please fill out an application on our company page, linked below, to be considered for this position:

• https://j.brt.mv/jb.do?reqGK=27706914&refresh=true

​​​​​​Benefits:

• Medical, Dental, Vision, Pharmacy, Life, & Disability
• 401K- Matching
• FSA
• Employee Assistance Program
• PTO and Company Paid Holidays

Schedule:

•  3 days a week in office in Portland, Oregon
  • Address: 601 SW 2nd Ave, Portland, OR 97204
• PST working hours
• Full time minimum 7.5 work days with 37.5 work weeks

Requirements:

1. College degree or equivalent work experience in the healthcare industry.
2. 2-5 years of experience in a clinical setting or working with healthcare providers.
3. 3-5 years of leadership experience.
4. Experience working with internal and external stakeholders, leadership, and healthcare staff to communicate and coordinate multiple initiatives and interventions.
5. Proven project management skills.  Ability to track and coordinate multiple complex projects simultaneously.
6. Strong facilitation skills with the ability to run provider meetings with a prioritized topic agenda
7. Demonstrated understanding of provider reimbursement and alternative payment models
8. Ability to evaluate complex analytic reports and convey key points to varying levels of report recipients.
9. Intermediate to advanced knowledge of state and national quality measure specifications.
10. Strong analytical, problem solving, decision making, organizational, and detail orientation skills.
11. Ability to work well under pressure, including frequent interruptions and shifting levels of priority.
12. Strong project related software skills including Microsoft office suite and comfortable learning new software applications.
13. Strong interpersonal and communication skills (both oral and written) with a customer service emphasis.
14. Ability to be self-sufficient, innovative, work independently and as a team in a fast-paced, multi-faceted environment.
15. Project a professional business image in writing, telephonically and in person.
16. Ability to maintain confidentiality.

Primary Functions:

1. Manage the Provider Engagement team and HIT Coordinator.
2. Ensure department objectives are achieved by training, mentoring, and otherwise supporting optimal performance of staff.
3. Oversee planning and management of multiple independent projects required to support strategic business relationship development including the improvement of provider performance measures and other metrics.
4. Develop project work plans, resource allocations, and budget impacts.
5. Oversees the completion of project tasks, problem resolution, tracking results and meeting/exceeding deliverables of the team.
6. Plan, organize, and implement workload assignments.  Monitor progress and coordinate changes in priorities and schedules to ensure work is completed in an efficient and timely manner.
7. Oversee quality assurance validations of project deliverables to ensure they meet the overall project standards and needs.
8. Assign project activities and tasks impacting a variety of outside entities and a diverse work force, including leadership and operational staff in multiple Moda business units.
9. Effectively communicate project status, project goals, results and milestones to all levels of internal staff and management as well as with vendors and external customers.
10. Track, monitor and report all project related issues and risks including mitigation solutions and follow up.
11. Establish return on investment (ROI) goals for the team, track results and provide periodic reporting to internal stakeholders.
12. Perform other duties and responsibilities as assigned.

​​​​​​Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. 

For more information regarding accommodations please direct your questions to Kristy Nehler and Daniel McGinnis via our humanresources@modahealth.com email.
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