Director, Provider Relations & Network Strategy

Molina Healthcare; New York (NY); Remote; USD 97,000 - 228,000; Full time

Job summary

Molina Healthcare in New York seeks a leader who directs the provider relations team for the New York Health Plan. You will support network development, network adequacy, and provider training, serving as the primary liaison between Molina and contracted providers.

You will oversee education, communications, issue intake, and compliance with Molina policies. Collaborate with network leadership and the corporate network team to standardize provider relationship management and services across the

Qualifications

• At least 8 years of provider services experience, including Medicaid/Medicare or Marketplace products.
• At least 3 years of management/leadership experience.
• Strong understanding of the health care delivery system and government-sponsored plans.
• Experience with provider compensation methodologies (FFS, capitation, risk, ASO, etc.).
• Strong organizational skills and attention to detail.
• Ability to manage multiple tasks and deadlines effectively.
• Experience preparing and presenting formal presentations.
• Strong interpersonal skills to interface with providers and staff.
• Ability to work in a cross-functional, matrixed organization.
• Excellent verbal and written communication skills.

Responsibilities

• Oversees provider relations function and daily operations of the department.
• Develops provider relations strategies and networks with providers and hospitals.
• Collaborates with network management and operations on provider services initiatives.
• Develops network planning tools and standardizes management processes.
• Provides matrix team support across markets and contracts.
• Builds provider training and education programs for staff and providers.
• Ensures compliance with state/federal requirements and plan policies.
• Leads communications, policies, training materials and reports for providers.

Skills

Provider services experience

Management/leadership

Health care delivery knowledge

Provider compensation methodologies

Organizational skills

Multi-task management

Formal presentations

Interpersonal skills

Cross-functional collaboration

Verbal and written communication

Microsoft Office proficiency

Tools

Microsoft Office Suite

Job description

Molina Healthcare in New York seeks a leader who directs the provider relations team for the New York Health Plan. You will support network development, network adequacy, and provider training, serving as the primary liaison between Molina and contracted providers.

You will oversee education, communications, issue intake, and compliance with Molina policies. Collaborate with network leadership and the corporate network team to standardize provider relationship management and services across the