Senior Provider Relations Specialist

Molina Talent Acquisition; Des Moines (IA); Remote; USD 85,000 - 120,000; Full time

Job summary

Molina Healthcare in Des Moines, IA is seeking a senior provider relations specialist to support provider education, network development, and compliance across the Molina network.

You will serve as the primary liaison between the plan and contracted providers, coordinating site visits, trainings and issue resolution while traveling 80%+.

The ideal candidate has 3+ years in provider services or related fields, strong communication, organizational, and cross-functional collaboration skills.

Qualifications

• At least 3 years of customer service, provider services, or claims experience.
• Understanding of the health care delivery system, including government-sponsored health plans.
• Understanding of provider compensation methodologies across Medicaid/Medicare.
• Experience delivering training and facilitating educational presentations.
• Strong organizational skills and attention to detail.
• Ability to manage multiple tasks and deadlines.
• Excellent verbal and written communication skills.
• Proficiency with Microsoft Office and related software.

Responsibilities

• Engage high-priority providers to support satisfaction and educate on Molina initiatives.
• Be primary contact between Molina health plan and complex provider community.
• Educate, advocate, and ensure policy compliance; drive issue resolution and portal adoption.
• Resolve cross-department issues involving senior leadership.
• Schedule and perform provider site visits to meet goals.
• Provide on-site training and counseling to providers.
• Troubleshoot provider problems and coordinate with Molina teams.
• Lead problem-solving meetings with providers and Molina stakeholders.
• Deliver trainings to providers and staff, including large groups.
• Promote participation in Molina initiatives and monitor CAHPS and quality programs.
• Serve as subject matter expert and train new team members.
• Role requires 80%+ travel.

Skills

Customer service

Provider services

Claims processing

Interpersonal skills

Verbal and written communication

Microsoft Office

Cross-functional collaboration

Organizational skills

Tools

Microsoft Office

Job description

Molina Healthcare in Des Moines, IA is seeking a senior provider relations specialist to support provider education, network development, and compliance across the Molina network.

You will serve as the primary liaison between the plan and contracted providers, coordinating site visits, trainings and issue resolution while traveling 80%+.

The ideal candidate has 3+ years in provider services or related fields, strong communication, organizational, and cross-functional collaboration skills.