Provider Quality Improvement Specialist

**JOB DESCRIPTION**

**Job Summary**

**The Specialist, Practice Transformation implements Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. Drives provider practices to ensure assigned Tier 2 & Tier 3 Practice Transformation plan is in place and carried out to meet annual quality & risk adjustment performance goals.**

**Job Duties**

+ Knowledge of HEDIS measures within Quality Improvement, specifically for Medicaid
+ Ensures assigned Tier 2 & Tier 3 providers have a Practice Transformation plan to meet annual quality & risk adjustment performance goals.
+ Drives provider partner coaching and collaboration to improve quality performance and risk adjustment accuracy through consistent provider meetings, action item development and execution.
+ Addresses challenges/barriers in the practice environment impeding successful attainment of program goals ...