Lead, Provider Network Administration & Data Quality

Molina Healthcare, Inc.; Tampa (FL); On-site; USD 50,000 - 97,000; Full time

Job summary

Molina Healthcare, Inc. in Tampa, FL is seeking an experienced leader to supervise the provider network administration team, ensuring accurate validation and maintenance of provider data across claims and provider databases, in alignment with business and system requirements.

You will oversee data review, SOP development, and cross‑functional collaboration with local and corporate partners to improve data quality, reporting, and operational efficiency; the role requires coaching staff, managing

Qualifications

• 5+ years of health care experience, incl. claims, provider services, or provider network operations; 3+ years with CPT/ICD codes.
• Experience with COB, subrogation, or eligibility criteria in claims processing.
• Strong data analysis and attention to detail.
• Excellent customer service and communication skills.
• Ability to manage multiple priorities and meet deadlines.
• Proficiency in MS Office and related software.

Responsibilities

• Oversee provider network administration activities including updating provider information in systems and reporting.
• Ensure provider data review/analytics for accuracy and timeliness.
• Maintain SOPs and procedures for provider demographic data.
• Ensure accuracy of provider entries in health plan systems.
• Educate health plan representatives on provider record setup.
• Collaborate with cross-functional teams to ensure data quality and resolve provider load issues.
• Identify PNA issues, implement best practices, and drive improvements.
• Lead monthly provider network administration meetings and generate reports for leadership.
• Develop standard reports for audit purposes and support related projects.
• Hire, train, and evaluate team members; provide coaching and performance management.

Skills

Healthcare industry experience

Claims processing

Data analysis

Customer service

Verbal & written communication

Project/workflow design

Attention to detail

Team leadership

Tools

Excel

Microsoft Office

Job description

Molina Healthcare, Inc. in Tampa, FL is seeking an experienced leader to supervise the provider network administration team, ensuring accurate validation and maintenance of provider data across claims and provider databases, in alignment with business and system requirements.

You will oversee data review, SOP development, and cross‑functional collaboration with local and corporate partners to improve data quality, reporting, and operational efficiency; the role requires coaching staff, managing