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Every career with Hearst Television is like a story. How it develops, where it takes you, the milestones you reach along the way – you’ve got a lot to look forward to as your unique career story unfolds. Hearst Television, a subsidiary of Hearst, owns and operates local television and radio stations serving nearly three dozen U.S. cities, reaching 24 million U.S. television households. Through its partnership with nearly all major networks, Hearst Television distributes national content across more than 120 video channels, including programming from ABC, NBC, CBS, CW, MY Net, MeTV, This TV, Estrella, and more. Hearst Television is recognized as one of the industry's premier companies. It has been honored with numerous awards for distinguished journalism and industry innovation, including the Walter Cronkite Award for political journalism, the national Edward R. Murrow Award, the DuPont-Columbia Award, and the George Foster Peabody Award.

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Provides support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers within the Molina network. Responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina policies and procedures.\nEssential Job Duties\nSuccessfully engages high-volume, high-visibility plan providers, to ensure provider satisfaction, facilitate education on key Molina initiatives, and improve coordination and partnership between the health plan and contracted providers.\nServes as the primary point of contact between Molina health plan and the non-complex provider community that services Molina members, including but not limited to fee-for-service (FFS) and pay-for-performance (P4P) providers.\nCollaborates directly with the plan's external providers to educate, advocate and engage as valuable partners - ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service; effectively drives timely issue resolution, electronic medical record (EMR) connectivity, and provider portal adoption.\nConducts regular provider site visits within assigned region/service area; determines daily or weekly schedule, to meet or exceed the plan's monthly site visit goals. Proactively engages with the provider and staff to determine; for example, non-compliance with Molina policies/procedures or Centers for Medicare and Medicaid Services (CMS) guidelines/regulations, or to assess the non-clinical quality of customer service provided to Molina members.\nProvides on-the-spot training and education as needed, including counseling providers diplomatically, while retaining a positive working relationship.\nIndependently troubleshoots provider problems as they arise, and takes initiative in preventing and resolving issues between the provider and the plan whenever possible. The types of questions, issues or problems that may emerge during visits are unpredictable and may range from simple to very complex or sensitive matters.\nInitiates, coordinates and participates in problem-solving meetings between the provider and Molina stakeholders, including senior leadership and physicians (examples include: issues related to utilization management, pharmacy, quality of care, and correct coding).\nIndependently delivers training and presentations to assigned providers and their staff - answering questions that come up on behalf of the health plan; may also deliver training and presentations to larger groups, such as leaders and management of provider offices, including large multispecialty groups or health systems, executive level decision makers, association meetings, and joint operating committees (JOCs).\nPerforms an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives; examples of such initiatives include: administrative cost-effectiveness, member satisfaction - Consumer Assessment of Healthcare Providers and Systems (CAHPS), regulatory-related, Molina quality programs, and taking advantage of electronic solutions (electronic data interchange (EDI), EMR, provider portal, provider website, etc.).\nMay provide training and support to new and existing provider relations team members as appropriate.\nRole requires 60%+ same-day or overnight travel (extent of same-day or overnight travel will depend on the specific health plan service area).\nRequired Qualifications\nAt least 2 years of customer service, provider services, or claims experience in a managed care or medical office setting, or equivalent combination of relevant education and experience.\nGeneral understanding of the health care delivery system, including government-sponsored health plans.\nOrganizational skills and attention to detail.\nAbility to manage multiple tasks and deadlines effectively.\nInterpersonal skills, including ability to interface with providers and medical office staff.\nAbility to work in a cross-functional highly matrixed organization.\nEffective verbal and written communication skills.\nMicrosoft Office suite and applicable software programs proficiency.\nPreferred Qualifications\nFamiliarity with various managed health care provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including: fee-for service (FFS), capitation and various forms of risk, ASO, etc.\nExperience delivering training and facilitating educational presentations.\nPay Range: $19.84 - $38.69 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.\nMolina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.\n","Provider Relations Support Specialist

Provides support for health plan provider relations activities. Supports network development, networ...","Representative, Health Plan Provider Relations (Residential Team Specialist - WI",[527],{"_458":459,"_454":528,"_452":529,"_456":530,"_484":531},"Madison","Madison, WI, United States, 53774","WI","53774",["B","2833171874"],"12 days ago","/jobs/2833171874-representative-health-plan-provider-relations-residential-team-specialist-wi","Representative, Health Plan Provider Relations (Residential Team ...","Madison, WI, United States","/jobs?location=Madison%2C+WI%2C+United+States","/jobs?keyword=Representative%2C+Health+Plan+Provider+Relations+%28Residential+Team+...",{"_435":434,"_439":540,"_468":469,"_460":461,"_248":523,"_446":524,"_433":434,"_113":525,"_437":199,"_438":199,"_470":469,"_448":199,"_449":541,"_431":546,"_471":472,"_436":120,"_485":547,"_476":548,"_487":535,"_488":549,"_490":491,"_492":550,"_494":538},["D",1772989200000],[542],{"_458":459,"_454":543,"_452":544,"_456":530,"_484":545},"Kenosha","Kenosha, WI, United States, 53142","53142",["B","2823032790"],"13 days ago","/jobs/2823032790-representative-health-plan-provider-relations-residential-team-specialist-wi","Kenosha, WI, United States","/jobs?location=Kenosha%2C+WI%2C+United+States",{"_435":434,"_439":552,"_468":469,"_460":461,"_248":553,"_446":554,"_433":434,"_113":555,"_437":199,"_438":199,"_470":469,"_448":199,"_449":556,"_431":561,"_471":472,"_436":120,"_485":562,"_476":563,"_487":555,"_488":564,"_490":491,"_492":565,"_494":566},["D",1773151200000],"JOB DESCRIPTION Job Summary

Provides support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers within the Molina network. Responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina policies and procedures.

Essential Job Duties

Successfully engages high-volume, high-visibility plan providers, to ensure provider satisfaction, facilitate education on key Molina initiatives, and improve coordination and partnership between the health plan and contracted providers.

Serves as the primary point of contact between Molina health plan and the non-complex provider community that services Molina members, including but not limited to fee-for-service (FFS) and pay-for-performance (P4P) providers.

Collaborates directly with the plan’s external providers to educate, advocate and engage as valuable partners - ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service; effectively drives timely issue resolution, electronic medical record (EMR) connectivity, and provider portal adoption.

Conducts regular provider site visits within assigned region/service area; determines daily or weekly schedule, to meet or exceed the plan's monthly site visit goals. Proactively engages with the provider and staff to determine; for example, non-compliance with Molina policies/procedures or Centers for Medicare and Medicaid Services (CMS) guidelines/regulations, or to assess the non-clinical quality of customer service provided to Molina members.

Provides on-the-spot training and education as needed, including counseling providers diplomatically, while retaining a positive working relationship.

Independently troubleshoots provider problems as they arise, and takes initiative in preventing and resolving issues between the provider and the plan whenever possible. The types of questions, issues or problems that may emerge during visits are unpredictable and may range from simple to very complex or sensitive matters.

Initiates, coordinates and participates in problem‑solving meetings between the provider and Molina stakeholders, including senior leadership and physicians (examples include: issues related to utilization management, pharmacy, quality of care, and correct coding).

Independently delivers training and presentations to assigned providers and their staff - answering questions that come up on behalf of the health plan; may also deliver training and presentations to larger groups, such as leaders and management of provider offices, including large multispecialty groups or health systems, executive level decision makers, association meetings, and joint operating committees (JOCs).

Performs an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives; examples of such initiatives include: administrative cost‑effectiveness, member satisfaction - Consumer Assessment of Healthcare Providers and Systems (CAHPS), regulatory‑related, Molina quality programs, and taking advantage of electronic solutions (electronic data interchange (EDI), EMR, provider portal, provider website, etc.).

May provide training and support to new and existing provider relations team members as appropriate.

Role requires 60%+ same-day or overnight travel (extent of same-day or overnight travel will depend on the specific health plan service area).

Required Qualifications

At least 2 years of customer service, provider services, or claims experience in a managed care or medical office setting, or equivalent combination of relevant education and experience.

General understanding of the health care delivery system, including government-sponsored health plans.

Organizational skills and attention to detail.

Ability to manage multiple tasks and deadlines effectively.

Interpersonal skills, including ability to interface with providers and medical office staff.

Ability to work in a cross‑functional highly matrixed organization.

Effective verbal and written communication skills.

Microsoft Office suite and applicable software programs proficiency.

Preferred Qualifications

Familiarity with various managed health care provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including: fee‑for‑service (FFS), capitation and various forms of risk, ASO, etc.

Experience delivering training and facilitating educational presentations.

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: $19.84 - $38.69 / HOURLY\n*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

#J-18808-Ljbffr\n","JOB DESCRIPTION Job Summary

Provides support for health plan provider relations activities. Supports network development, network adequacy...","Representative, Health Plan Provider Relations",[557],{"_458":459,"_454":558,"_452":559,"_456":530,"_484":560},"Milwaukee","Milwaukee, WI, United States, 53244","53244",["B","2840996250"],"11 days ago","/jobs/2840996250-representative-health-plan-provider-relations","Milwaukee, WI, United States","/jobs?location=Milwaukee%2C+WI%2C+United+States","/jobs?keyword=Representative%2C+Health+Plan+Provider+Relations",{"_435":434,"_439":568,"_468":469,"_460":461,"_248":569,"_446":570,"_433":434,"_113":442,"_437":199,"_438":199,"_470":469,"_448":199,"_449":571,"_431":577,"_471":472,"_436":120,"_485":486,"_476":578,"_487":442,"_488":579,"_490":491,"_492":580,"_494":495},["D",1773572400000],"Overview\nProvides support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers within the Molina network. Responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina policies and procedures.

Essential Job Duties

Successfully engages high-volume, high-visibility plan providers, to ensure provider satisfaction, facilitate education on key Molina initiatives, and improve coordination and partnership between the health plan and contracted providers.

Serves as the primary point of contact between Molina health plan and the non-complex provider community that services Molina members, including but not limited to fee-for-service (FFS) and pay-for-performance (P4P) providers.

Collaborates directly with the plan’s external providers to educate, advocate and engage as valuable partners - ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service; effectively drives timely issue resolution, electronic medical record (EMR) connectivity, and provider portal adoption.

Conducts regular provider site visits within assigned region/service area; determines daily or weekly schedule, to meet or exceed the plan's monthly site visit goals. Proactively engages with the provider and staff to determine; for example, non-compliance with Molina policies/procedures or Centers for Medicare and Medicaid Services (CMS) guidelines/regulations, or to assess the non-clinical quality of customer service provided to Molina members.

Provides on-the-spot training and education as needed, including counseling providers diplomatically, while retaining a positive working relationship.

Independently troubleshoots provider problems as they arise, and takes initiative in preventing and resolving issues between the provider and the plan whenever possible. The types of questions, issues or problems that may emerge during visits are unpredictable and may range from simple to very complex or sensitive matters.

Initiates, coordinates and participates in problem-solving meetings between the provider and Molina stakeholders, including senior leadership and physicians (examples include: issues related to utilization management, pharmacy, quality of care, and correct coding).

Independently delivers training and presentations to assigned providers and their staff - answering questions that come up on behalf of the health plan; may also deliver training and presentations to larger groups, such as leaders and management of provider offices, including large multispecialty groups or health systems, executive level decision makers, association meetings, and joint operating committees (JOCs).

Performs an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives; examples include: administrative cost-effectiveness, member satisfaction - CAHPS, regulatory-related, Molina quality programs, and taking advantage of electronic solutions (EDI, EMR, provider portal, provider website, etc.).

May provide training and support to new and existing provider relations team members as appropriate.

Role requires 60%+ same-day or overnight travel (extent of same-day or overnight travel will depend on the specific health plan service area).

Required Qualifications

At least 2 years of customer service, provider services, or claims experience in a managed care or medical office setting, or equivalent combination of relevant education and experience.

General understanding of the health care delivery system, including government-sponsored health plans.

Organizational skills and attention to detail.

Ability to manage multiple tasks and deadlines effectively.

Interpersonal skills, including ability to interface with providers and medical office staff.

Ability to work in a cross-functional highly matrixed organization.

Effective verbal and written communication skills.

Microsoft Office suite and applicable software programs proficiency.

Preferred Qualifications

Familiarity with various managed health care provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including: fee-for service (FFS), capitation and various forms of risk, ASO, etc.

Experience delivering training and facilitating educational presentations.

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

#J-18808-Ljbffr\n","Overview\nProvides support for health plan provider relations activities. Supports network development, network adequacy and provider training and e...",[572],{"_458":459,"_454":573,"_452":574,"_456":575,"_484":576},"Long Beach","Long Beach, CA, United States, 90899","CA","90899",["B","2890444542"],"/jobs/2890444542-representative-health-plan-provider-relations-remote-texas","Long Beach, CA, United States","/jobs?location=Long+Beach%2C+CA%2C+United+States",{"_435":434,"_439":582,"_468":469,"_460":461,"_248":583,"_446":584,"_433":434,"_113":525,"_437":199,"_438":199,"_470":469,"_448":199,"_449":585,"_431":587,"_471":472,"_436":120,"_485":588,"_476":589,"_487":535,"_488":536,"_490":491,"_492":537,"_494":538},["D",1772874000000],"Job Summary

Provides support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers within the Molina network. Responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina policies and procedures.\nEssential Job Duties

Successfully engages high-volume, high-visibility plan providers, to ensure provider satisfaction, facilitate education on key Molina initiatives, and improve coordination and partnership between the health plan and contracted providers.\nServes as the primary point of contact between Molina health plan and the non-complex provider community that services Molina members, including but not limited to fee-for-service (FFS) and pay-for-performance (P4P) providers.\nCollaborates directly with the plan’s external providers to educate, advocate and engage as valuable partners - ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service; effectively drives timely issue resolution, electronic medical record (EMR) connectivity, and provider portal adoption.\nConducts regular provider site visits within assigned region/service area; determines daily or weekly schedule, to meet or exceed the plan's monthly site visit goals. Proactively engages with the provider and staff to determine; for example, non-compliance with Molina policies/procedures or Centers for Medicare and Medicaid Services (CMS) guidelines/regulations, or to assess the non-clinical quality of customer service provided to Molina members.\nProvides on-the-spot training and education as needed, including counseling providers diplomatically, while retaining a positive working relationship.\nIndependently troubleshoots provider problems as they arise, and takes initiative in preventing and resolving issues between the provider and the plan whenever possible. The types of questions, issues or problems that may emerge during visits are unpredictable and may range from simple to very complex or sensitive matters.\nInitiates, coordinates and participates in problem-solving meetings between the provider and Molina stakeholders, including senior leadership and physicians (examples include: issues related to utilization management, pharmacy, quality of care, and correct coding).\nIndependently delivers training and presentations to assigned providers and their staff - answering questions that come up on behalf of the health plan; may also deliver training and presentations to larger groups, such as leaders and management of provider offices, including large multispecialty groups or health systems, executive level decision makers, association meetings, and joint operating committees (JOCs).\nPerforms an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives; examples of such initiatives include: administrative cost-effectiveness, member satisfaction - CAHPS, regulatory-related, Molina quality programs, and taking advantage of electronic solutions (EDI, EMR, provider portal, provider website, etc.).\nMay provide training and support to new and existing provider relations team members as appropriate.\nRole requires 60%+ same-day or overnight travel (extent of same-day or overnight travel will depend on the specific health plan service area).\nRequired Qualifications

At least 2 years of customer service, provider services, or claims experience in a managed care or medical office setting, or equivalent combination of relevant education and experience.\nGeneral understanding of the health care delivery system, including government-sponsored health plans.\nOrganizational skills and attention to detail.\nAbility to manage multiple tasks and deadlines effectively.\nInterpersonal skills, including ability to interface with providers and medical office staff.\nAbility to work in a cross-functional highly matrixed organization.\nEffective verbal and written communication skills.\nMicrosoft Office suite and applicable software programs proficiency.\nPreferred Qualifications

Familiarity with various managed health care provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including: fee-for service (FFS), capitation and various forms of risk, ASO, etc.\nExperience delivering training and facilitating educational presentations.\nTo all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.\nMolina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V\nPay Range: $19.84 - $38.69 / HOURLY\n*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

#J-18808-Ljbffr\n","Job Summary

Provides support for health plan provider relations activities. Supports network development, network adequacy and provider tr...",[586],{"_458":459,"_454":528,"_452":536,"_456":530},["B","2809120416"],"15 days ago","/jobs/2809120416-representative-health-plan-provider-relations-residential-team-specialist-wi","actionData","errors"]