Senior Provider Relations Specialist

Molina Healthcare; Oceanside (CA); On-site; USD 73,000 - 112,000; Full time

Job summary

Molina Healthcare is seeking a senior Provider Relations professional to support health plan provider relations activities in the Oceanside area. The role serves as the main liaison between Molina and contracted providers, driving network management, provider education, and timely issue resolution while ensuring policy compliance and excellent customer service.

Responsibilities include engaging high-priority providers, educating them on Molina initiatives, coordinating with senior leadership,

Qualifications

• 3+ years of customer service or provider services experience in a managed care or medical office setting.
• Understanding of the health care delivery system and government-sponsored plans.
• Experience delivering training and facilitating educational presentations.
• Organizational skills and attention to detail.
• Ability to manage multiple tasks and deadlines.
• Strong interpersonal and verbal/written communication skills.
• Proficiency with Microsoft Office and related software.

Responsibilities

• Engage top priority and high-volume providers to ensure satisfaction and education on Molina initiatives.
• Serve as primary contact between Molina and complex provider community (FFS and P4P).
• Collaborate with external providers to educate, advocate and ensure compliance with Molina policies.
• Resolve complex provider issues across departments and with senior leadership when needed.
• Conduct regular provider site visits and schedule optimization to meet goals.
• Provide on-the-spot training and education to providers and staff.
• Troubleshoot provider problems and coordinate problem-solving with Molina stakeholders.

Skills

Customer service

Provider services

Training delivery

Communication

Organizational skills

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a senior Provider Relations professional to support health plan provider relations activities in the Oceanside area. The role serves as the main liaison between Molina and contracted providers, driving network management, provider education, and timely issue resolution while ensuring policy compliance and excellent customer service.

Responsibilities include engaging high-priority providers, educating them on Molina initiatives, coordinating with senior leadership,