Provider Relations Representative - Remote

Overview

The Provider Relations Representative is responsible for network development, provider training, and ensuring compliance with Molina Healthcare policies while providing excellent customer service.

In Short

• Primary contact between Molina Healthcare and contracted providers.
• Educates and advocates for providers to ensure compliance with policies.
• Resolves complex provider issues involving senior leadership.
• Conducts regular provider site visits to assess compliance and quality.
• Provides on-the-spot training and education to providers.
• Initiates problem-solving meetings with providers and Molina stakeholders.
• Delivers training and presentations to providers and their staff.
• Monitors and enforces company policies to improve provider effectiveness.
• Requires 80%+ same-day or overnight travel.

Requirements

• Bachelor’s Degree or equivalent experience in managed healthcare.
• 3-5 years of customer service or provider service experience.
• 3+ years in managed healthcare administration or Provider Services.
• Familiarity with managed healthcare provider compensation methodologies.
• 5+ years of experience preferred in managed healthcare administration.
• 3+ years in provider contract negotiations preferred.

Benefits

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