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Provider Relations Representative - Remote

Posted 7 weeks ago
Customer Service
Full Time
CA, USA

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.
  • Conducts provider site visits and ensures compliance with policies.
  • Provides training and education to providers and their staff.
  • Independently troubleshoots issues and escalates when necessary.
  • Coordinates problem-solving meetings with providers and Molina stakeholders.
  • Delivers presentations to provider offices and larger groups.
  • Monitors and enforces company policies to improve provider effectiveness.
  • Requires 60%+ same-day or overnight travel.

Requirements

  • Associate's Degree or equivalent experience in managed healthcare.
  • 2-3 years of customer service or provider service experience.
  • Familiarity with managed healthcare provider compensation methodologies.
  • Bachelor’s Degree preferred.
  • 3+ years of experience in managed healthcare administration preferred.

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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