Provider Contracts Manager
Molina Healthcare Arizona; Long Beach, California; Meridian, Idaho; Idaho Falls, Idaho; Nebraska; Cleveland, Ohio; Dallas, Texas; Salt Lake City, Utah; Orem, Utah; Washington; Spokane, Washington; Green Bay, Wisconsin; Phoenix, Arizona; Savannah, Georgia; Idaho; Nampa, Idaho; Kearney, Nebraska; Omaha, Nebraska; New Mexico; Santa Fe, New Mexico; Rochester, New York; San Antonio, Texas; Texas; Provo, Utah; Bellevue, Washington; Scottsdale, Arizona; Miami, Florida; Sioux City, Iowa; Bowling Green, Kentucky; Ann Arbor, Michigan; Grand Island, Nebraska; Lincoln, Nebraska; Las Cruces, New Mexico; Syracuse, New York; Buffalo, New York; Fort Worth, Texas; West Valley City, Utah; Milwaukee, Wisconsin; Racine, Wisconsin; Florida; Tampa, Florida; Columbus, Georgia; Boise, Idaho; Lexington-Fayette, Kentucky; Owensboro, Kentucky; Grand Rapids, Michigan; Detroit, Michigan; Roswell, New Mexico; Madison, Wisconsin; Wisconsin; Tucson, Arizona; Des Moines, Iowa; Michigan; New York; Yonkers, New York; Dayton, Ohio; Houston, Texas; Layton, Utah; Vancouver, Washington; Jacksonville, Florida; St. Petersburg, Florida; Atlanta, Georgia; Georgia; Augusta, Georgia; Iowa; Caldwell, Idaho; Kentucky; Albuquerque, New Mexico; New York, New York; Ohio; Utah; Tacoma, Washington; Kenosha, Wisconsin; Mesa, Arizona; Louisville, Kentucky; Bellevue, Nebraska; Chandler, Arizona; Orlando, Florida; Macon, Georgia; Cedar Rapids, Iowa; Davenport, Iowa; Iowa City, Iowa; Covington, Kentucky; Sterling Heights, Michigan; Warren, Michigan; Rio Rancho, New Mexico; Akron, Ohio; Cincinnati, Ohio; Columbus, Ohio; Austin, Texas; Seattle, Washington Job ID 2030394***Remote and must live in the United States***
JOB DESCRIPTION
Job Summary
Negotiates National agreements with highly visible providers including integrated delivery systems, hospitals and physician groups that result in high quality, cost effective and marketable providers.
KNOWLEDGE/SKILLS/ABILITIES
- In conjunction with Director/Manager Provider Contracts, negotiates high priority physician group and facility contracts using Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines.
- Develops and maintains provider contracts in APTTUS contract management software.
- Targets and recruits additional providers to reduce member access grievances.
- Engages targeted contracted providers in renegotiation of rates and/or language. Assists with cost control strategies that positively impact the Medical Care Ratio (MCR) within each region.
- Maintains contractual relationships with significant/highly visible providers.
- Advises Network Provider Contract Coordinators and Specialists on negotiation of individual provider and routine ancillary contracts.
- Evaluates provider network and implement strategic plans with the goal of meeting Molina's network adequacy standards.
- Assesses contract language for compliance with Corporate standards and regulatory requirements and review revised language with assigned MHI attorney.
- Participates in fee schedule determinations including development of new reimbursement models. Seeks input on new reimbursement models from Corporate Network Management and legal.
- Educates internal customers on provider contracts.
- Participates on the management team and other committees addressing the strategic goals of the department and organization.
JOB QUALIFICATIONS
Required Education
Bachelor's Degree in a healthcare related field or an equivalent combination of education and experience.
Required Experience
5-7 years
Preferred Education
Graduate degree
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $77,969 - $155,508 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina 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.
Job Type: Full Time Posting Date: 02/27/2025ABOUT OUR LOCATION
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