Job Description
Join Molina Healthcare as a Provider Relations Manager, where you will have a significant impact on nurturing strong connections with our network of contracted providers. Your leadership in network development, provider education, and compliance will align with Molina's mission and values, promoting quality care for our members.
Job Summary
As a key member of the Provider Relations team, you will manage daily operations while collaborating with various departments to enhance provider services. You will be the primary contact for our providers, addressing inquiries and resolving issues effectively.
Key Responsibilities
Lead the Provider Relations team to ensure seamless operations and foster collaboration across departments.
Develop and implement provider contracting strategies that align with health plan objectives.
Provide essential training and support for external provider representatives on policies and compliance standards.
Enhance provider network development and deliver education on procedures and reimbursement policies.
Implement tracking tools to monitor issue resolution and compliance with regulations.
Address provider concerns and complaints promptly, ensuring effective communication.
Design initiatives that build strong, positive relationships with providers, hospitals, and facilities.
Engage providers in initiatives to improve HEDIS scores and overall quality of care.
Communicate key information regarding cost control initiatives and care quality metrics.
Manage the Integrated Health Home (IHH) program in accordance with departmental standards.
Travel approximately 10-20% of the time to support your regions.
Job Qualifications
Required Education:
Bachelor's Degree in a Health or Business-related field or equivalent experience.
Required Experience/Knowledge, Skills & Abilities:
5-7 years of experience with Medicaid and/or Medicare products.
5+ years in managed healthcare environments.
Proven experience in collaboration with community agencies and providers.
Knowledge of various compensation methodologies in managed healthcare settings.
Experience delivering formal presentations effectively.
At least 2 years in a leadership role.
A minimum of 2 years managing employees.
Preferred Education:
Master's Degree in a Health or Business-related field.
Preferred Experience:
5-7 years in managed healthcare administration.
Experience in provider services, operations, and contract negotiations.
Molina Healthcare offers a competitive compensation and benefits package. We are proud to be an Equal Opportunity Employer (EOE) M/F/D/V.
Salary Range: $80,168 - $149,028 / ANNUAL.
*Actual compensation may vary based on geographic location, experience, education, and/or skill level.