Provider Contracts Manager
Molina Healthcare 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; 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 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 Contract Directors and Molina leadership, negotiates high priority physician group and facility contracts using Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines.
- Targets and recruits additional providers to meet business objectives.
- 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.
- Managers complex contracts for multiple states..
- 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.
#PJHPO
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
View Map- National Contracting Director Grand Rapids Michigan, Grand Island Nebraska, Lincoln Nebraska, Rio Rancho New Mexico, Austin Texas, Tucson Arizona, Des Moines Iowa, Sioux City Iowa, Caldwell Idaho, Lexington-Fayette Kentucky, Michigan, Nebraska, Omaha Nebraska, Albuquerque New Mexico, Orem Utah, Provo Utah, Bellevue Washington, Spokane Washington, Green Bay Wisconsin, Kenosha Wisconsin, Mesa Arizona, St. Petersburg Florida, Atlanta Georgia, Idaho, Owensboro Kentucky, Warren Michigan, Kearney Nebraska, New Mexico, Syracuse New York, Dallas Texas, Houston Texas, Orlando Florida, Cedar Rapids Iowa, Ann Arbor Michigan, Buffalo New York, New York, Vancouver Washington, Georgia, Savannah Georgia, Macon Georgia, Davenport Iowa, Idaho Falls Idaho, Louisville Kentucky, Bowling Green Kentucky, Cleveland Ohio, Dayton Ohio, Columbus Ohio, Texas, Layton Utah, Racine Wisconsin, Kentucky, Bellevue Nebraska, Yonkers New York, Akron Ohio, Ohio, Madison Wisconsin, Scottsdale Arizona, Phoenix Arizona, Jacksonville Florida, Florida, Augusta Georgia, Meridian Idaho, Covington Kentucky, Santa Fe New Mexico, Las Cruces New Mexico, Rochester New York, San Antonio Texas, Tacoma Washington, Washington, Chandler Arizona, Miami Florida, Tampa Florida, Columbus Georgia, Iowa City Iowa, Boise Idaho, Detroit Michigan, Sterling Heights Michigan, Roswell New Mexico, Cincinnati Ohio, Fort Worth Texas, Salt Lake City Utah, Utah, West Valley City Utah, Milwaukee Wisconsin, Wisconsin, Iowa, Nampa Idaho 02/27/2025
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