Provider Relations Manager - Health Plan Networks

Molina Healthcare; Springfield (IL); On-site; USD 63,000 - 124,000; Full time

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare is seeking an experienced Provider Relations professional in Illinois. The role leads provider relations activities, supports network development, and acts as the primary liaison between Molina and contracted providers.

Responsibilities include educating providers on Molina initiatives, resolving cross-department issues, and conducting site visits to meet monthly goals. Travel is 60%+. Strong presentation and relationship-building skills are essential.

Qualifications

• 6+ years in provider services across Medicaid/Medicare or Marketplace.
• Strong knowledge of the health care delivery system and government-sponsored plans.
• Experience with FFS, capitation, and risk-based contracts across lines of business.
• Ability to manage multiple tasks and deadlines.
• Experience presenting formal presentations to providers.
• Proficiency with Microsoft Office and related software.

Responsibilities

• Engage plan’s highest priority provider community and complex contracts to improve satisfaction and education.
• Serve as the primary contact between Molina health plan and contracted providers.
• Educate, advocate, and engage external providers on Molina initiatives.
• Resolve cross-department provider issues including contracting, finance, quality, and operations.
• Conduct provider site visits and plan schedules to meet monthly goals.
• Provide on-the-spot training and education to providers.
• Troubleshoot provider problems and coordinate with plan stakeholders.
• Lead problem-solving meetings among providers and Molina leadership.
• Deliver trainings and presentations to providers and management groups.
• Monitor provider satisfaction survey results and enforce policies.
• Develop strategic network planning tools and standard procedures.
• Travel 60%+ as required.

Skills

Provider relations

Communication skills

Presentations

Cross-functional teamwork

MS Office

Travel 60%+

Tools

EMR connectivity

Provider portal

Job description

Molina Healthcare is seeking an experienced Provider Relations professional in Illinois. The role leads provider relations activities, supports network development, and acts as the primary liaison between Molina and contracted providers.

Responsibilities include educating providers on Molina initiatives, resolving cross-department issues, and conducting site visits to meet monthly goals. Travel is 60%+. Strong presentation and relationship-building skills are essential.