Remote Hedis Jobs in Boca Raton, FL (NOW HIRING)

JOB DESCRIPTION Job Summary

Provides senior level support for health education activities.  Responsible for developing, implementing, and maintaining health plan health education programs.  Assists in identifying health education program needs, researching and developing health education and disease management materials, and maintenance of member quality programs.  Conducts data collection, reporting, and monitoring in accordance with established state/federal/National Committee for Quality Assurance (NCQA) standards and regulations.

This position is focused on Asthma care and is seeking experience in asthma instruction with a preferred AE-C.  Please make sure to include any experience in this qualifier on your resume.  This is for a pediatric population. 

Essential Job Duties

• Develops, implements and evaluates health education programs for members within the Molina network and the broader community.  
• Provides oversight and assistance to providers in meeting health education contract requirements.  
• Serves as a resource for health educators in the resolution of issues that may arise during the implementation of quality improvement (QI) interventions. 
• Identifies, designs, implements, and evaluates health education interventions to meet the needs of the targeted population based on priorities established by the department and current contracts. 
• Conducts population, geographic, and member-specific needs assessments.
• Coordinates the health education services assessment of Independent Physician Association (IPAs) and medical groups as required and collaborates with other quality improvement (QI) staff on oversight.
• Represents as a liaison to internal departments, community-based organizations (CBOs), social service agencies and public health departments to ensure that Molina resource information is current and available.
• Participates in the development of internal resources in collaboration with other departments identified in the annual work plan. 
• Reviews and updates health education materials and programs, including preventive care guidelines, incentive packets, the health plan website and communications to providers. 
• Successfully engages members in health promotion via direct member calls.
• Coordinates care of members from call tracking boxes and health education voicemails, including connecting members to appropriate programs and resources.
• May collaborate with various grant recipients, state and local entities that work toward improving the health of Molina members.
• Participates in QI planning and project work to further QI goals (e.g., Healthcare Effectiveness Data and Information Set (HEDIS) activities, strategic planning, and special projects).
• Provides input on the design and functionality of all utilized databases.
• May serve as the designated QI representative at various external activities to include immunization, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT), chronic condition collaborative and other work group meetings.
• Participates in QI planning and project work to further QI goals (e.g., HEDIS activities, and special projects).
• Provides training and support to new and existing health education team members.
• This position may require same day out of office travel 0 - 80% 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 a health education-related capacity, and at least 1 of year experience working with a wide range of member populations within a managed care setting, or equivalent combination of relevant education and experience. 
• Ability to build relationships with community-based organizations (CBOs).
• Strong customer service skills.
• Knowledge of available community resources.
• Knowledge and understanding of HEDIS and NCQA.
• Critical-thinking, problem-solving and analytical skills.
• Ability to navigate change with flexibility and a positive outlook.
• Effective verbal, written and interpersonal communication skills.
• Microsoft Office suite and applicable software programs proficiency, and ability to learn new information systems and software programs.
 

Preferred Qualifications

• Experience with Medicaid, Medicare, and/or Marketplace government-sponsored programs.  
• Experience working with the Medicaid population.
• Certified Health Education Specialist (CHES).
 

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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: $49,930 - $90,363 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.