Provider Network Administration Lead

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

Job summary

Molina Healthcare, Inc. Tampa, FL area is seeking a senior operations professional to lead a team in provider network administration, validating and maintaining provider data across claims and databases.

You will drive data quality, reporting, and SOP development, ensuring timely updates and educated health plan representatives. This role requires strong leadership, attention to detail, and collaboration with multiple departments.

Qualifications

• 5+ years of health care experience including claims, provider services, or provider network operations.
• Experience with CPT/ICD-9/ICD-10 codes or equivalent knowledge.
• Attention to detail and ability to ensure accurate data entry and delivery.
• Data analysis skills and customer service aptitude.
• Strong verbal and written communication and workflow design experience.

Responsibilities

• Oversees provider network administration activities including updating provider information in systems and reporting.
• Manages data review/analytics to ensure accurate provider demographics and attachments.
• Maintains SOPs and ensures accuracy of provider entries in health plan systems.
• Educates health plan representatives on provider record setup and quality.
• Collaborates across departments to resolve provider data issues and loads.
• Identifies issues, resolves problems, and implements best practices.
• Documents monthly provider network operations meetings and generates required reporting.
• Develops standard reports for audit purposes and supports network administration projects.
• Hires, trains, and evaluates team members with ongoing coaching and development.

Skills

Healthcare experience

Data analysis

Attention to detail

Customer service

Communication skills

Microsoft Excel

Workflow design

Tools

SQL

Microsoft Office

Job description

Molina Healthcare, Inc. Tampa, FL area is seeking a senior operations professional to lead a team in provider network administration, validating and maintaining provider data across claims and databases.

You will drive data quality, reporting, and SOP development, ensuring timely updates and educated health plan representatives. This role requires strong leadership, attention to detail, and collaboration with multiple departments.