Senior Provider Relations Specialist

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

Job summary

Molina Healthcare is seeking a senior-level Provider Relations Specialist to support health plan provider relations activities, network development and provider education across the Molina network. You will serve as the primary liaison between the plan and contracted providers, manage provider education, satisfaction, issue intake and ensure policy compliance.

This role requires extensive travel (80%+), engagement with high-priority providers, and collaboration across multiple departments to

Qualifications

• At least 3 years of customer service, provider services, or claims experience in a managed care or medical office setting, or equivalent combination of relevant education and experience.
• Understanding of the health care delivery system, including government-sponsored health plans.
• Experience delivering training and facilitating educational presentations.
• Organizational skills and attention to detail.
• Ability to manage multiple tasks and deadlines effectively.
• Interpersonal skills, including ability to interface with providers and medical office staff.
• Ability to work in a cross-functional highly matrixed organization.
• Effective verbal and written communication skills.
• Microsoft Office suite and applicable software programs proficiency.

Responsibilities

• Engages high-priority, high-volume providers to improve satisfaction and coordination.
• Acts as primary contact between Molina and complex provider community (FFS and P4P).
• Educates providers on Molina policies and procedures; promotes EMR connectivity and provider portal adoption.
• Resolves complex provider issues across departments and leadership levels.
• Conducts regular provider site visits and schedules for regional goals.
• Delivers on-the-spot training and education with diplomacy.
• Troubleshoots provider problems and prevents issues with Molina.
• Leads problem-solving meetings with stakeholders and physicians.
• Delivers trainings and presentations to provider offices and groups.

Skills

Customer service

Provider services

Claims experience

Training delivery

Organizational skills

Communication

Multitasking

Cross-functional collaboration

Tools

Microsoft Office

Healthcare software

Job description

Molina Healthcare is seeking a senior-level Provider Relations Specialist to support health plan provider relations activities, network development and provider education across the Molina network. You will serve as the primary liaison between the plan and contracted providers, manage provider education, satisfaction, issue intake and ensure policy compliance.

This role requires extensive travel (80%+), engagement with high-priority providers, and collaboration across multiple departments to