Provider Contracts Director (Must reside in Georgia)

Molina Healthcare; Georgia; Remote; USD 97,000 - 190,000; Full time

Job summary

A regional health services company is seeking an experienced professional for a Provider Contracts position. The role involves developing provider contracts, monitoring network adequacy, and collaborating with business development. Candidates should have a Bachelor's Degree and over 7 years of experience in healthcare administration. This remote position is based in Georgia, offering a competitive salary range from $97,299 to $189,732 annually.

Benefits

Competitive benefits package

Qualifications

• 7+ years’ experience in Healthcare Administration, Managed Care, Provider Contracting and/or Provider Services.
• Strong negotiation skills and experience in network management.

Responsibilities

• Develop and implement standardized provider contracts.
• Monitor and report network adequacy.
• Collaborate to determine provider contracting strategies.

Skills

Healthcare Administration

Provider Contracting

Network Management

Negotiation

Education

Bachelor's Degree in a related field

Master's Degree

Job description

Remote and must live in Georgia

Job Description

Knowledge/Skills/Abilities

• Plans, organizes, staffs, and coordinates the Provider Contracts activities for contracts. Works with direct management, senior leadership/management, Corporate, and staff to develop and implement standardized provider contracts and contracting strategies.
• Monitors and reports network adequacy to leadership for all lines of business when leading or assisting with a new market campaign or expansion.
• In conjunction with direct management and senior leadership, for new builds collaborates with Business Development to determine provider contracting strategies, and for new builds and expansions identifies specialties and geographic locations on which to concentrate resources for purposes of establishing a sufficient network of Participating Providers to serve the health care needs of members and patients.
• Advises in preparation and negotiations of provider contracts and oversee negotiation of contracts in concert with established company guidelines with physicians, hospitals, and other health care providers.
• Utilizes standardized contract templates and the PADU process.
• Collaborates with the Value Based Care team to understand new value-based care programs and provider targets.
• Communicates new strategies to corporate provider network leadership for input.
• Utilize standardized system(s) to track contract negotiation activity on an ongoing basis throughout the year until contract implementation is complete.
• Participates on committees addressing the strategic goals of the department and organization.
• Works with Legal and Corporate Network Management as needed to modify contract templates to ensure compliance with all contractual and/or regulatory requirements as Molina expands its footprint for all lines of business.
• Establishes, nurtures and manages relationships with area agencies, community provider partners and local Molina staff to support and advance Plan initiatives.

Job Qualifications

• REQUIRED EDUCATION: Bachelor\'s Degree in a related field (Business Administration, etc.) or equivalent experience.
• REQUIRED EXPERIENCE: 7+ years’ experience in Healthcare Administration, Managed Care, Provider Contracting and/or Provider Services.
• PREFERRED EDUCATION: Master\'s Degree
• PREFERRED EXPERIENCE: 6+ years in Provider Network contracting

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

#PJCorp

Pay Range: $97,299 - $189,732 / ANNUAL
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.