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As part of Molina’s response to the COVID-19 pandemic, unless otherwise prohibited by law, new hires with a start date of November 1, 2021 or later will be required to be fully vaccinated.

Provider Services Manager

Molina Healthcare Reno, Nevada Job ID 2009145
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JOB FUNCTION:

Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations.  Provider Services staff are the primary point of contact between Molina Healthcare and contracted provider network.  They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service.

KNOWLEDGE, SKILLS & ABILITIES (Generally, the occupational knowledge and specific technical and professional skills and abilities required to perform the essential duties of this job):

• Develops and deploys strategic network planning tools to drive Provider Services and Contracting Strategy across the enterprise.

• Facilitates strategic planning and documentation of network management standards and processes.

• Works collaboratively with functional business unit stakeholders to lead and/or support various provider services functions with an emphasis on developing and implementing standards and best practices sharing across the organization.

• MCST matrix team environmental support including, but not limited to:  New Markets Provider/Contract Support Services, PCRP & CSST resolution support, and National Contract Management support services.

REQUIRED EDUCATION:

BA or BS Degree or commensurate/equivalent

REQUIRED EXPERIENCE:

• 5 years provider contract network development and management experience in a managed healthcare setting.

• Project management experience.

• Working familiarity with various managed healthcare provider compensation methodologies, including but not limited to:  fee-for service, capitation and various forms of risk, ASO, etc.

REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:

PREFERRED EDUCATION:

MA or MS preferred

PREFERRED EXPERIENCE:

• 10 years experience in managed healthcare administration.

• Experience with provider contract negotiations in a Medicare managed healthcare setting, ideally in negotiating different provider contract types (e.g., physician, group and hospital contracting, etc.).

PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:

N/A

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: 07/13/2021

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