Provider Network Contracting Specialist - Remote

Overview

The Provider Network Contracting Specialist is responsible for negotiating contracts with complex providers to ensure high-quality, cost-effective healthcare services in alignment with Molina Healthcare's mission and regulatory compliance.

In Short

• Negotiate contracts with complex providers including hospitals and physician groups.
• Develop and maintain provider contracts in management software.
• Engage providers in renegotiation of rates and contract terms.
• Advise on negotiation of individual provider contracts.
• Evaluate provider networks to meet adequacy standards.
• Participate in fee schedule determinations and reimbursement model development.
• Educate internal teams on provider contracts.
• Communicate contract terms clearly to providers.
• Participate in strategic management team discussions.
• Travel regularly to meet provider needs.

Requirements

• Bachelor’s Degree in a healthcare-related field.
• 5-7 years of contract-related experience in healthcare.
• 3+ years in provider contract negotiations.
• Familiarity with managed healthcare compensation methodologies.
• Master's Degree preferred.
• 3+ years in Provider Network contracting preferred.

Benefits

• Competitive benefits and compensation package.
• Equal Opportunity Employer.