Director, Provider Contracts / Dental Market Segment - REMOTE
Passport Health Plan by Molina Healthcare Bowling Green, Kentucky; Louisville, Kentucky; Lexington-Fayette, Kentucky; Owensboro, Kentucky; Covington, Kentucky; Georgetown, Kentucky; Richmond, Kentucky; Florence, Kentucky; Nicholasville, Kentucky Job ID 2027774Passport Health Plan by Molina Healthcare has a mission to provide quality health care to those who need it, no matter their circumstances. Today, Molina health plans serve 3,331,000 members across the country through government-funded programs. Each day, we work to earn the trust our partners and members put in us, so they can lean on Molina. Together, Passport Health Plan and Molina share a commitment to improving the health and quality of life of our members across the Commonwealth of Kentucky.
- Full Time, Part Time
- Level: All Levels
- Travel: Occassional
Success Profile
What makes you successful at Passport Health Plan by Molina Healthcare? Check out the traits we’re looking for and see if you're the right fit!
- Compassionate
- Consultive
- Patient
- Problem-Solver
- Sincere
- Relationship Expertise
Benefits
-
Insurance
Medical · Dental · Vision
Group & Voluntary Life Insurance
Aflac · Pet Health · Identity Theft
Auto & Home Insurance -
Savings
Flexible Spending Accounts
401K · Roth 401K
Employee Stock Purchase Plan -
Career Growth
Continuing Education Units
Education Reimbursement -
Time Off
Paid Time Off
Volunteer Time Off
Company Holidays -
Additional Perks
Legal Assistance Plan
Employee Assistance & Well Being Programs
Employee Perks Platform
Rideshare Portal
Responsibilities
KNOWLEDGE/SKILLS/ABILITIES
Plans, organizes, staffs, and coordinates the Provider Contracts activities for contracts at a National Level. Works with direct management, senior leadership/management, Corporate, and staff to develop and implement standardized provider contracts and contracting strategies.
- Monitors and reports network adequacy for Medicare and Medicaid services.
- In conjunction with direct management and senior leadership, oversees development of provider contracting strategies, identifying those specialties and geographic locations on which to concentrate resources for purposes of establishing a sufficient network of Participating Providers to serve the health care needs of members and patients.
- Advises in preparation and negotiations of provider contracts and oversee negotiation of contracts in concert with established company guidelines with physicians, hospitals, and other health care providers.
- Utilizes standardized contract templates and Pay for Performance strategies.
- Develops and maintains Reimbursement Tolerance Parameters (across multiple specialties/ geographies). Oversees the development of new reimbursement models in concert with direct management and senior leadership/management.
- Communicates new strategies to corporate provider network leadership for input.
- Utilize standardized system(s) to track contract negotiation activity on an ongoing basis throughout the year.
- Participates on the management team and other committees addressing the strategic goals of the department and organization.
- Oversees the maintenance of all Provider Contract templates. Works with Legal and Corporate Network Management as needed to modify contract templates to ensure compliance with all contractual and/or regulatory requirements.
- Manages the relationship with area agencies and community provider partners to support and advance Plan initiatives.
- Develops and implements strategies to comply with state, federal, NCQA, HEDIS initiatives and regulations.
JOB QUALIFICATIONS
Required Education
Bachelor's Degree in a related field (Business Administration, etc.) or equivalent experience.
Required Experience
- 7+ years’ experience in Healthcare Administration, Managed Care, Provider Contracting and/or Provider Services.
- Min. 2 years’ experience managing/supervising employees.
Preferred Education
Master's Degree
Preferred Experience
6+ years in Provider Network contracting in Dental market segment.
Experience leading Provider Contract, Provider Data Management, and Provider Relations teams.
Dental Provider Contract experience.
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: $87,568.7 - $189,732.18 / 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: 08/30/2024ABOUT OUR LOCATION
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