Senior Provider Relations Specialist

Molina Healthcare; Yakima (WA); Remote; USD 83,000 - 112,000; Full time

Job summary

Molina Healthcare is seeking a senior Provider Relations professional in the United States to support health plan provider relations activities, network development, and provider education. The role acts as the main liaison between Molina and contracted providers and ensures compliance with Molina policies and procedures.

Responsibilities include engaging top providers, improving coordination with the provider community, delivering on-site training, and driving issue resolution, EMR

Qualifications

• At least 3 years in customer service, provider services, or claims in a managed care or medical office setting.
• Understanding of the health care delivery system, including government-sponsored health plans.
• Experience delivering training and facilitating educational presentations.
• Strong organizational, multitasking and interpersonal skills.
• Proficiency in Microsoft Office and related software programs.

Responsibilities

• Engage high-priority 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, advocate and engage providers to ensure policy compliance and high customer service levels.
• Coordinate problem-solving with leadership and physicians on complex provider issues.
• Deliver training and presentations to providers and staff.
• Monitor and enforce Molina policies; promote participation in initiatives such as CAHPS and EDI/EMR adoption.

Skills

Customer service

Provider services

Claims experience

Communication skills

Organizational skills

Multitasking

Interpersonal skills

MS Office

Tools

EMR

EDI

Provider portal

Job description

Molina Healthcare is seeking a senior Provider Relations professional in the United States to support health plan provider relations activities, network development, and provider education. The role acts as the main liaison between Molina and contracted providers and ensures compliance with Molina policies and procedures.

Responsibilities include engaging top providers, improving coordination with the provider community, delivering on-site training, and driving issue resolution, EMR