Senior Provider Relations & Contracting Specialist

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

Job summary

Molina Healthcare in Michigan seeks an experienced Provider Relations professional to support health plan provider relations, network development, and training. You will serve as the primary contact between Molina and contracted providers, ensuring adherence to policies and procedures and improving provider satisfaction and access.

The role involves engaging high-priority providers, conducting site visits, delivering on-the-spot education, coordinating with leadership, and traveling within

Qualifications

• At least 3 years in customer service, provider services, or claims in managed care or medical office setting.
• Understanding of healthcare delivery system, including government plans.
• Knowledge of provider compensation methodologies (FFS, capitation, risk, ASO).
• Experience delivering training and educational presentations.
• Strong organizational skills and attention to detail.
• Ability to manage multiple tasks and deadlines.
• Strong interpersonal and communication skills.
• Proficient in Microsoft Office and related software.

Responsibilities

• Engage high-priority and complex providers to ensure satisfaction and education on Molina initiatives.
• Serve as primary contact between Molina and the complex provider community including FFS and P4P providers.
• Educate and communicate policies, drive provider portal adoption and EMR connectivity.
• Resolve cross-department provider issues and coordinate with senior leadership as needed.
• Conduct regular provider site visits and plan schedules to meet monthly goals.
• Provide on-the-spot training and counseling to providers and staff.
• Lead problem-solving meetings between providers and Molina stakeholders.
• Deliver trainings to provider offices and larger groups as required.
• Monitor and enforce Molina policies, promote participation in initiatives.

Skills

Customer service

Provider services

Claims experience

Organizational skills

Multitasking

Communication skills

MS Office proficiency

Job description

Molina Healthcare in Michigan seeks an experienced Provider Relations professional to support health plan provider relations, network development, and training. You will serve as the primary contact between Molina and contracted providers, ensuring adherence to policies and procedures and improving provider satisfaction and access.

The role involves engaging high-priority providers, conducting site visits, delivering on-the-spot education, coordinating with leadership, and traveling within