Senior Provider Relations & Contracting Specialist

Molina Healthcare; Bay City (MI); On-site; USD 50,000 - 97,000; Full time

Job summary

Molina Healthcare in Michigan seeks a Senior Provider Relations Specialist to lead education, communication, and problem solving with contracted providers within the Molina network. You will manage provider satisfaction, training, and CMS/compliance initiatives while coordinating with leadership.

The role requires regional site visits, strong collaboration across departments, and the ability to resolve complex provider issues.

Qualifications

• 3+ years in customer service, provider services, or claims in managed care or medical office setting.
• Understanding of health care delivery system and government-sponsored plans.
• Knowledge of Medicaid/Medicare provider payment methods (FFS, capitation, risk).
• Experience delivering training and presentations.
• Strong organizational skills and attention to detail.
• Ability to manage multiple tasks and deadlines.
• Strong interpersonal and communication skills.
• Proficiency in Microsoft Office and related software.

Responsibilities

• Engage high-priority providers to ensure satisfaction and education on Molina initiatives.
• Serve as primary contact between Molina and complex provider community (FFS, P4P).
• Collaborate to educate, advocate, and ensure policy compliance while delivering excellent customer service; drive issue resolution and EMR/provider portal adoption.
• Resolve cross-department issues and coordinate with senior leadership.
• Conduct regular provider site visits and schedule planning to meet monthly goals.
• Provide on-the-spot training and diplomatically counsel providers to maintain relationships.
• Troubleshoot provider problems and preemptively resolve provider-plan issues.
• Lead problem-solving meetings with providers and Molina stakeholders, including executives.
• Deliver training/presentations to providers and their staff, from small groups to large multispecialty organizations.
• Promote participation in Molina initiatives like CAHPS and EDI/EMR/e-provider tooling.

Skills

Customer service

Provider services

Claims experience

Training delivery

Organizational skills

Multitasking

Interpersonal skills

Verbal and written communication

Microsoft Office

Job description

Molina Healthcare in Michigan seeks a Senior Provider Relations Specialist to lead education, communication, and problem solving with contracted providers within the Molina network. You will manage provider satisfaction, training, and CMS/compliance initiatives while coordinating with leadership.

The role requires regional site visits, strong collaboration across departments, and the ability to resolve complex provider issues.