Manager, Provider Data Configuration - California PDM - Remote
Molina Healthcare Ohio; New Mexico; Idaho; Davenport, Iowa; Bowling Green, Kentucky; Salt Lake City, Utah; Sterling Heights, Michigan; Tampa, Florida; Kenosha, Wisconsin; Kearney, Nebraska; Cedar Rapids, Iowa; Georgia; Racine, Wisconsin; Iowa City, Iowa; Dayton, Ohio; Cincinnati, Ohio; Roswell, New Mexico; Augusta, Georgia; Grand Island, Nebraska; Idaho Falls, Idaho; Bellevue, Washington; Caldwell, Idaho; Nampa, Idaho; Washington; New York; Florida; Akron, Ohio; Albuquerque, New Mexico; Grand Rapids, Michigan; Louisville, Kentucky; Milwaukee, Wisconsin; Spokane, Washington; Boise, Idaho; Sioux City, Iowa; Dallas, Texas; Chandler, Arizona; Des Moines, Iowa; Columbus, Georgia; Tucson, Arizona; Miami, Florida; Detroit, Michigan; Vancouver, Washington; Albany, New York; Austin, Texas; Owensboro, Kentucky; Tacoma, Washington; Michigan; Buffalo, New York; Meridian, Idaho; Mesa, Arizona; Columbus, Ohio; Rochester, New York; Orlando, Florida; Covington, Kentucky; Green Bay, Wisconsin; Santa Fe, New Mexico; Las Cruces, New Mexico; Lexington-Fayette, Kentucky; Rio Rancho, New Mexico; Fort Worth, Texas; Atlanta, Georgia; Bellevue, Nebraska; West Valley City, Utah; St. Petersburg, Florida; Wisconsin; Iowa; Utah; Ann Arbor, Michigan; Jacksonville, Florida; San Antonio, Texas; Syracuse, New York; Madison, Wisconsin; Warren, Michigan; Provo, Utah; Scottsdale, Arizona; Everett, Washington; Savannah, Georgia; Lincoln, Nebraska; Kentucky; Layton, Utah; Yonkers, New York; Macon, Georgia; Houston, Texas; Texas; Nebraska; Omaha, Nebraska; Phoenix, Arizona; Orem, Utah; Cleveland, Ohio Job ID 2032412JOB DESCRIPTION
Job Summary
Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
KNOWLEDGE/SKILLS/ABILITIES
- Establish and maintain internal standard operating procedures, and enterprise-wide policies and procedures pertaining to Provider functions ensuring alignment with business objectives.
- Collaborate with departments on issues related to provider, including but not limited to, Configuration, Business Systems, Encounters (inbound and outbound), Claims, Provider Services and Contracting.
- Assist in design and development of new programs as related to transitions and implementations of existing plans with regards to provider data.
- Organizational expert in responding to legislative and regulatory developments and audits as it relates to provider information. Supports others in facing out to regulators in developing and implementing appropriate Corrective Action Plans for submission of provider network files, etc.
- Act as an expert in handling complaints and other escalated issues from internal customers.
JOB QUALIFICATIONS
Required Education
Bachelor's Degree or equivalent combination of education and experience
Required Experience
5-7 years
Preferred Education
Graduate Degree or equivalent combination of education and experience
Preferred Experience
7-9 years
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: $80,412 - $188,164 / 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: 07/07/2025ABOUT OUR LOCATION
View Map- Supervisor, Care Review (RN) Atlanta Georgia, Orlando Florida, Idaho Falls Idaho, Idaho, New Mexico, Green Bay Wisconsin, Bowling Green Kentucky, Phoenix Arizona, Meridian Idaho, Milwaukee Wisconsin, Houston Texas, Bellevue Nebraska, Iowa, St. Petersburg Florida, Cleveland Ohio, Madison Wisconsin, Buffalo New York, Yonkers New York, Albany New York, Savannah Georgia, Lincoln Nebraska, Nampa Idaho, Tacoma Washington, Iowa City Iowa, Layton Utah, Albuquerque New Mexico, Sterling Heights Michigan, Warren Michigan, Kenosha Wisconsin, Louisville Kentucky, Columbus Georgia, Roswell New Mexico, Cedar Rapids Iowa, Spokane Washington, Bellevue Washington, Caldwell Idaho, Michigan, Dayton Ohio, Las Cruces New Mexico, Lexington-Fayette Kentucky, Cincinnati Ohio, Rio Rancho New Mexico, Columbus Ohio, Kearney Nebraska, Rochester New York, Macon Georgia, Everett Washington, Wisconsin, New York, Davenport Iowa, Salt Lake City Utah, Tampa Florida, Augusta Georgia, Detroit Michigan, Vancouver Washington, Owensboro Kentucky, Boise Idaho, Utah, Nebraska, Georgia, Racine Wisconsin, Akron Ohio, San Antonio Texas, Santa Fe New Mexico, Miami Florida, Kentucky, Washington, Florida, Ohio, Covington Kentucky, Omaha Nebraska, Orem Utah, Des Moines Iowa, Tucson Arizona, Grand Island Nebraska, Provo Utah, Scottsdale Arizona, Austin Texas, Texas, West Valley City Utah, Sioux City Iowa, Ann Arbor Michigan, Jacksonville Florida, Syracuse New York, Grand Rapids Michigan, Dallas Texas, Chandler Arizona, Mesa Arizona, Fort Worth Texas 07/07/2025
- RN Care Manager - Behavioral Health Bowling Green Kentucky, Covington Kentucky, Owensboro Kentucky, United States, Louisville Kentucky, Lexington-Fayette Kentucky 07/07/2025
- Senior Provider Relations Representative Louisville Kentucky, Lexington-Fayette Kentucky, Bowling Green Kentucky 07/07/2025
- Correspondence Processor: California Long Beach California, Los Angeles California 07/02/2025
No recently viewed jobs.
View All JobsNo saved jobs.
View All Jobs