Strategic Provider Relations Lead

Molina Healthcare; Charleston (IL); On-site; USD 63,000 - 124,000; Full time

Job summary

Molina Healthcare is seeking a Provider Relations Lead to support Central & Southern IL and act as the primary liaison between Molina and contracted providers. You will oversee provider education, satisfaction, and network management while ensuring policy compliance and timely issue resolution.

The role requires extensive travel (60%+), collaboration across departments, and the ability to drive provider engagement within Medicaid, Medicare, and Marketplace plans.

Qualifications

• 6+ years of provider services experience with Medicaid, Medicare, and/or Marketplace products.
• Strong understanding of the health care delivery system and government-sponsored plans.
• Experience with provider compensation methodologies including FFS, capitation, and risk.
• Proven ability to interface with providers and medical office staff.
• Excellent organizational skills with the ability to handle multiple tasks and deadlines.

Responsibilities

• Engage high-priority provider community including complex contracts to ensure satisfaction and education.
• Serve as the primary Molina contact for non-complex provider groups and education on Molina initiatives.
• Collaborate with external providers to educate, advocate and drive EMR connectivity and portal adoption.
• Resolve cross-department issues involving contracting, finance, quality, and operations, up to senior leadership.
• Conduct regular provider site visits to meet monthly goals and ensure policy compliance.
• Deliver trainings and presentations to providers and their staff, including large groups.

Tools

Microsoft Office Programmes

EMR systems

Provider portal

Job description

Molina Healthcare is seeking a Provider Relations Lead to support Central & Southern IL and act as the primary liaison between Molina and contracted providers. You will oversee provider education, satisfaction, and network management while ensuring policy compliance and timely issue resolution.

The role requires extensive travel (60%+), collaboration across departments, and the ability to drive provider engagement within Medicaid, Medicare, and Marketplace plans.