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Provider Relations Representative - Remote

Posted 13 weeks ago
Customer Service
Full Time
MI, USA

Overview

The Provider Relations Representative is responsible for network development, provider training, and ensuring compliance with Molina Healthcare policies while delivering high levels of customer service.

In Short

  • Primary contact between Molina Healthcare and contracted providers.
  • Educates and advocates for providers to ensure satisfaction.
  • Resolves complex provider issues across departments.
  • Responsible for provider satisfaction survey results.
  • Develops strategic network planning tools.
  • Conducts regular provider site visits.
  • Delivers training and presentations to providers.
  • Monitors compliance with company policies.
  • Requires 60%+ same-day or overnight travel.
  • Trains other Provider Relations Representatives.

Requirements

  • Bachelor's Degree in a healthcare related field.
  • 4-6 years of provider contract network relations experience.
  • Experience with managed healthcare provider compensation methodologies.
  • Master's Degree in Health or Business preferred.
  • 5 years experience in managed healthcare administration preferred.
  • Experience in provider services and contract negotiations 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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