Senior Provider Relations Specialist

Molina Healthcare; Cedar Rapids (IA); Remote; USD 47,000 - 97,000; Full time

Job summary

Molina Healthcare in Cedar Rapids, IA is seeking a senior provider relations professional to lead network development, education, and engagement within the Molina network. You will serve as the primary liaison between the health plan and contracted providers, ensuring policy compliance and high levels of provider satisfaction.

The role requires extensive field travel, ongoing training delivery, site visits, and collaboration with leadership to address complex issues and improve coordination of

Qualifications

• 3+ years in customer service, provider services, or claims in managed care or medical office settings.
• Understanding of the health care delivery system and government-sponsored plans.
• Experience delivering trainings and educational presentations.
• Strong organizational skills with the ability to manage multiple tasks and deadlines.
• Excellent verbal and written communication skills.
• Proficiency with Microsoft Office and applicable software.

Responsibilities

• Engage high-priority, high-volume providers to improve satisfaction and education on Molina initiatives.
• Serve as primary contact between Molina and complex provider community (FFS, P4P).
• Collaborate with external providers to educate, advocate, and ensure compliance with Molina policies.
• Resolve complex provider issues across departments and with senior leadership.
• Conduct regular provider site visits and manage scheduling to meet monthly goals.
• Provide on-the-spot training and education with a positive working relationship.
• Troubleshoot provider problems and drive timely issue resolution with stakeholders.
• Initiate and participate in problem-solving meetings on utilization management, pharmacy, quality, and coding.
• Deliver trainings and presentations to providers and staff, including large groups and executives.
• Monitor and enforce policies to increase provider effectiveness and participation in Molina initiatives.
• Serve as a subject matter expert for provider relations and mentor team members.
• 80%+ travel, including same-day or overnight visits.

Skills

Customer service

Provider services

Claims experience

Interpersonal skills

Verbal and written communication

Microsoft Office proficiency

Tools

Microsoft Office

Job description

Molina Healthcare in Cedar Rapids, IA is seeking a senior provider relations professional to lead network development, education, and engagement within the Molina network. You will serve as the primary liaison between the health plan and contracted providers, ensuring policy compliance and high levels of provider satisfaction.

The role requires extensive field travel, ongoing training delivery, site visits, and collaboration with leadership to address complex issues and improve coordination of