Senior Provider Relations & Contracting Specialist

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

Job summary

Molina Healthcare in Michigan seeks a senior provider relations professional to support network development, education, and high-level provider engagement within the Molina network.

The role focuses on serving as the primary liaison to complex providers, ensuring policy compliance and collaboration across departments. Strong customer service, training delivery, and EMR/EDI familiarity are essential.

Qualifications

• 3+ years in customer service, provider services, or claims in managed care.
• Understanding of health care delivery systems.
• Knowledge of Medicaid/Medicare provider compensation methods.
• Experience delivering trainings and presentations.
• Strong organizational skills and attention to detail.
• Ability to manage multiple tasks and deadlines.
• Excellent verbal and written communication.
• Proficiency with Microsoft Office and related software.

Responsibilities

• Engage top priority, high-volume providers to ensure satisfaction and education on Molina initiatives.
• Serve as the primary contact between Molina and complex provider community (FFS, P4P).
• Collaborate with external providers to ensure policy compliance and promote provider portal adoption.
• Resolve complex provider issues across departments and leadership levels.
• Conduct regular provider site visits and schedule optimization to meet goals.
• Provide on-the-spot training and diplomatically counsel providers.
• Lead problem-solving meetings with providers and Molina stakeholders.
• Deliver training and presentations to providers and their staff, including large groups.
• Promote participation in Molina initiatives and EMR/EDI solutions.
• Monitor policy adherence and improve provider effectiveness through education.
• Act as a subject matter expert for provider relations.
• Support training for new and existing provider relations staff.

Skills

Customer service

Provider services

Claims experience

Organizational skills

Communication skills

Interpersonal skills

Microsoft Office proficiency

Tools

Microsoft Office

Job description

Molina Healthcare in Michigan seeks a senior provider relations professional to support network development, education, and high-level provider engagement within the Molina network.

The role focuses on serving as the primary liaison to complex providers, ensuring policy compliance and collaboration across departments. Strong customer service, training delivery, and EMR/EDI familiarity are essential.