The Provider Relations Manager will provide subject matter expertise and leadership for health plan provider relations activities, supporting network development, network adequacy, and provider training and education. The role will also serve as the 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.
Requirements
- At least 6 years of provider services experience, including experience supporting individual/group providers, hospitals, integrated delivery systems, and ancillary providers with Medicaid, Medicare, and or Marketplace products, or equivalent combination of relevant education and experience.
- Strong understanding of the health care delivery system, including government-sponsored health plans.
- Experience 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.
- Previous experience with community agencies and providers.
- Strong organizational skills and attention to detail.
- Ability to manage multiple tasks and deadlines effectively.
- Experience with preparing and presenting formal presentations.
- Strong interpersonal skills, including ability to interface with providers and medical office staff.
- Ability to work in a cross-functional highly matrixed organization.
- Strong verbal and written communication skills.
- Microsoft Office suite and applicable software programs proficiency.
Benefits
- Competitive benefits and compensation package
