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Provider Contracts Specialist - Remote

Posted 16 weeks ago
Finance / Legal
Full Time
CA, USA

Overview

The Molina Health Plan Provider Network Contracting role focuses on network strategy and development, ensuring compliance with regulations while maintaining financial and operational performance.

In Short

  • Responsible for contracting and re-contracting standard deals.
  • Maintains network adequacy and handles issue escalations.
  • Executes fee-for-service contracts with minimal negotiations.
  • Ensures accurate maintenance of provider information.
  • Validates data for provider databases.
  • Communicates contract terms and reimbursement rates to providers.
  • Participates in network development and strategic planning.
  • Coordinates the contracting process and document distribution.
  • Travels regularly to meet targeted needs.
  • Engages in special projects related to contracting.

Requirements

  • Associate’s Degree in a related field or equivalent experience.
  • 2-4 years of provider contract support or negotiation experience.
  • Preferred: Bachelor’s Degree in a related field.
  • Preferred: 1-3 years of managed care experience.

Benefits

  • Competitive benefits and compensation package.
  • Equal Opportunity Employer (EOE) M/F/D/V.

M.T.A

Molina Talent Acquisition

Molina Healthcare is a leading provider of managed healthcare services, dedicated to improving the health of its members through high-quality, cost-effective care. The company focuses on network strategy and development, ensuring compliance with federal, state, and local regulations while aligning with its core values and strategic goals. Molina Healthcare emphasizes the importance of building strong relationships with complex providers, including hospitals and physician groups, to enhance network adequacy and financial performance. With a commitment to value-based care, Molina Healthcare actively engages in contract negotiations and innovative reimbursement models to meet the diverse needs of its members.

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