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.
• Educate and advocate for providers to ensure compliance with policies.
• Resolve complex provider issues involving senior leadership.
• Conduct regular provider site visits to assess compliance and quality.
• Deliver training and presentations to providers and their staff.
• Monitor and enforce company policies to improve provider effectiveness.
• Travel required for site visits (40%+ same-day or overnight).
• 3-5 years of experience in customer service or provider services required.
• Bachelor’s degree or equivalent experience in managed healthcare.
• Preferred experience in provider contract negotiations.

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.
• Familiarity with provider compensation methodologies.
• 5+ years in managed healthcare preferred.
• 3+ years in provider contract negotiations preferred.

Benefits

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