Quality Liaison, Provider Engagement & Outreach

Job Type(s)

Full Time

Industry

Healthcare

• Provide SME level support and collaboration with MVPs Provider and Network teams.
• Monitor and manage performance of providers, networks and CBOs for Medicare and Medicaid using data to drive decisions, provide insights and actionable recommendations.
• Support and implement the Provider and Quality strategies to achieve top rated outcomes, maintain compliance and optimal customer and provider satisfaction.
• Maintains cross-functional relationships with other MVP departments, including but not limited to, Analytics, Risk Adjustment, IT and Technical teams, Health Management, and Operations, to ensure efficient and coordinated efforts.
• Represent MVP's Quality team at regular and ad hoc meetings with Providers, CBOs, and other community partners.
• Prepare, draft, or publish materials for internal and external presentations.
• Review, audit, and validate medical records and/or supplemental data.
• Other duties as assigned to achieve Quality performance objectives for Medicaid and Medicare.

• Clinical opening - Bachelor's degree in health care, nursing, business, or related field

• 2+ years Medicare Stars required.
• 2+ years Medicaid required.
• 2+ years in a Managed Care, Health System or Provider office focused on Quality Improvement and Quality Management required.

• 2+ years in healthcare and clinical information required.
• Experience working with claims, EMR, HIE and/or other medical management systems strongly preferred.
• Technical experience with supplemental data, HEDIS medical records review strongly preferred.
• Clinical license strongly preferred. (Ex: Registered Nurse, Social Work)

• Demonstrated proficiency with Microsoft Office (Excel, Word. Power Point, Outlook, Teams)
• Demonstrated proficiency with data analysis to guide decisions.
• Demonstrated experience documenting, monitoring and quantifying outcomes.
• Demonstrated success in working with Providers, Network, CBOs and health care consumers to achieve improvement in health outcomes and clinical performance.
• Demonstrated experience with implementation, execution and monitoring performance against a strategic goal and regulatory requirements.
• Excellent oral and written communications and interpersonal skills are required.
• Excellent critical thinking, problem solving, and time management skills are required.
• Ability to multi-task and work independently is required.

• Considerable paid time away from work including PTO (Paid Time Off), s ick t ime, service t ime o ff, p aid h olidays, and f loating h olidays , allowing you to take time off when it suits you best.
• Competitive 401(k) employer matching and profit-sharing program to help you save for your retirement.
• Low premium health benefits including medical, dental, and vision coverage to support your well-being and that of your family.
• Life insurance and disability coverage to ensure financial security for you and your dependents.
• An array of optional benefit plans such as accident insurance and specified disease coverage to protect you from the unexpected.
• Full tuition reimbursement (up to the IRS limit) for approved courses and programs that support continuous learning.
• A best-in-class employee Well-Being program to support all dimensions of your health and wellness.

• Job Family Medical Management/Clinical
• Pay Type Salary
• Min Hiring Rate $56,200.00
• Max Hiring Rate $110,319.00