Molina Healthcare Provider Services Manager in Irving, Texas

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.

Knowledge/Skills/Abilities • 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.

Job Qualifications

Required Experience • 5 years provider contract network development and management experience in a managed healthcare setting. • Home Health • 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. Preferred Education BA or BS preferred Preferred Experience • 10 years experience in Managed Care administration. • Experience with Provider Services in a Medicaid/Medicare Managed Care setting.

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.


Job: *Health Plans

Organization: *Health Plans

Title: Provider Services Manager

Location: TX-Irving-TXIRV

Requisition ID: 177989