Provider Quality Coordinator (Remote in WI)

Molina Healthcare; Long Beach (CA); Remote; USD 50,000 - 90,000; Full time

Job summary

An established industry player in healthcare services is seeking a dedicated individual for a field-based position that emphasizes provider satisfaction and healthcare delivery. This role offers a unique opportunity to engage with healthcare providers and senior leaders, ensuring compliance with policies while providing essential training and support. With a focus on career advancement and a collaborative work environment, this position allows you to make a meaningful impact in the healthcare sector. If you're passionate about improving provider relationships and enhancing healthcare delivery, this opportunity is perfect for you.

Benefits

Competitive benefits and compensation package

Career advancement opportunities

Supportive work environment

Qualifications

• 2-3 years of experience in customer service or provider service in managed care.
• Strong communication and organizational skills are essential.

Responsibilities

• Act as the primary contact between employer and provider network, ensuring compliance.
• Conduct site visits to assess provider compliance and quality of service.

Skills

Customer Service

Provider Service

Project Management

Communication Skills

Organizational Skills

Education

Associate's Degree

Bachelor's Degree

Job description

Employer Industry: Healthcare Services

Why consider this job opportunity:

1. Opportunity for career advancement and growth within the organization
2. Competitive benefits and compensation package
3. Work in a field-based position with significant interaction with healthcare providers
4. Chance to make a positive impact on provider satisfaction and healthcare delivery
5. Engage with senior leaders and physicians to improve coordination and partnerships
6. Supportive and collaborative work environment

What to Expect (Job Responsibilities):

1. Serve as the primary point of contact between the employer and contracted provider network, ensuring compliance with policies and procedures
2. Conduct regular site visits within the assigned region, assessing provider compliance and quality of customer service
3. Provide on-the-spot training and education to providers and their staff
4. Troubleshoot problems independently and coordinate meetings to resolve issues with stakeholders
5. Deliver training and presentations to assigned providers, management, and larger groups

What is Required (Qualifications):

1. Associate's Degree or equivalent experience in provider contract, network development, or project management in a managed healthcare setting
2. 2-3 years of customer service, provider service, or claims experience in a managed care environment
3. Familiarity with various managed healthcare provider compensation methodologies, particularly in Medicaid and Medicare
4. Ability to travel 60%+ for same-day or overnight visits
5. Strong communication and organizational skills

How to Stand Out (Preferred Qualifications):

1. Bachelor's Degree in a related field or equivalent combination of education and experience
2. 3+ years of experience in managed healthcare administration and/or Provider Services