Senior Health Plan Provider Relations Lead

Molina Healthcare; Peoria (IL); On-site; USD 85,000 - 120,000; Full time

Job summary

Molina Healthcare in Illinois is seeking an experienced Provider Relations Leader to oversee health plan provider interactions, network development, and training across the state (excluding Cook County). The role serves as the primary liaison between Molina and contracted providers, ensuring alignment with policies and high standards of service.

The incumbent leads engagement with high-priority provider groups, coordinates site visits, facilitates education on Molina initiatives, and drives

Qualifications

• Experience in provider relations within health plans.
• Strong communication and training skills.
• Ability to manage multiple stakeholders and complex contracts.
• Knowledge of CMS guidelines and Molina policies.

Responsibilities

• Engage high-priority provider community including value-based contracts to improve coordination.
• Serve as primary contact between Molina health plan and non-complex provider community.
• Educate providers on Molina initiatives and ensure policy compliance.
• Resolve complex provider issues across departments.
• Conduct regular provider site visits and plan visits to meet goals.
• Deliver training and presentations to providers and staff.
• Monitor provider satisfaction and support CAHPS-related efforts.

Job description

Molina Healthcare in Illinois is seeking an experienced Provider Relations Leader to oversee health plan provider interactions, network development, and training across the state (excluding Cook County). The role serves as the primary liaison between Molina and contracted providers, ensuring alignment with policies and high standards of service.

The incumbent leads engagement with high-priority provider groups, coordinates site visits, facilitates education on Molina initiatives, and drives