Skip to main content
Search Jobs
Search

Let us search jobs for you based on the skills and experience listed in your LinkedIn profile.

Start Matching Jobs
close message

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.

Senior Provider Services Representative (preferred candidates in Clark & Washoe counties)

Molina Healthcare Reno, Nevada Job ID 2010644
Apply Now

JOB DESCRIPTION

Job Summary

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.

PLEASE NOTE: Clark County candidates must be able to travel to Washoe County and this includes overnight stays of 1 - 5 business days. Travel-related expenses will be reimbursed. 

KNOWLEDGE/SKILLS/ABILITIES

  • Under general supervision, responsible for various provider services functions with an emphasis on working externally with the Plan's highest priority, high volume, strategic providers to educate, advocate and engage as valuable partners.
  • Requires an in-depth knowledge of provider services and contracting subject matter expertise.
  • Resolves complex provider issues that may cross departmental lines and involve Senior Leadership.
  • Serves as a subject matter expert for other departments.
  • Trains other Provider Services Representatives, as appropriate.

JOB QUALIFICATIONS

Required Education

Bachelor's Degree or equivalent provider contract, network development and management, or project management experience in a managed healthcare setting.

Required Experience

  • 3 - 5 years customer service, provider service, or claims experience in a managed care setting.
  • 3-5 years’ experience in managed healthcare administration and/or Provider Services.
  • 5 years’ experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc.
  • Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to; fee-for service, capitation, and various forms of risk, ASO, etc.

Preferred Education

Bachelor's or master’s degree.

Preferred Experience

  • 5+ years’ experience in managed healthcare administration and/or Provider Services.
  • 5+ years’ experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc.

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.

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: 10/07/2021

ABOUT OUR LOCATION

View Map

Job Alerts

Sign up to receive automatic notices when jobs that match your interests are posted.

By uploading your resume you are not submitting an application for employment

Interested InSelect a job category from the list of options. Search for a location and select one from the list of suggestions. Finally, click “Add” to create your job alert.

  • Health Plan Operations, Reno, Nevada, United StatesRemove