Strategic Provider Relations Manager

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

Job summary

Molina Healthcare is seeking a Provider Relations leader to support Central & Southern Illinois providers. You will lead relations activities, network development, and provider education while ensuring policy compliance and high satisfaction across the Molina network.

The role requires 60%+ travel and collaboration with cross-functional teams to resolve issues and implement strategic initiatives. A deep understanding of Medicaid/Medicare programs is essential.

Qualifications

• 6+ years of provider services experience in Medicaid/Medicare or Marketplace products.
• Strong understanding of the health care delivery system and government-sponsored plans.
• Experience with provider compensation methodologies (FFS, capitation, risk, ASO).
• Excellent interpersonal skills and ability to interface with providers and staff.
• Ability to manage multiple tasks in a cross-functional, matrixed environment.

Responsibilities

• Engage high-priority provider community to educate and align with Molina initiatives.
• Serve as primary contact between Molina and contracted providers.
• Educate, advocate and engage providers to ensure policy compliance and high service levels.
• Resolve complex issues across contracting, finance, quality, and operations; coordinate with senior leadership.
• Plan and conduct provider site visits; assess non-compliance and provider performance.
• Deliver training and presentations to providers and their staff; support large groups and meetings.

Skills

Provider relations

Communication

Presentation

Cross-functional

Tools

MS Office

Job description

Molina Healthcare is seeking a Provider Relations leader to support Central & Southern Illinois providers. You will lead relations activities, network development, and provider education while ensuring policy compliance and high satisfaction across the Molina network.

The role requires 60%+ travel and collaboration with cross-functional teams to resolve issues and implement strategic initiatives. A deep understanding of Medicaid/Medicare programs is essential.