Strategic Provider Relations Manager

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

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare in Quincy, IL seeks an experienced Provider Relations Specialist to lead and optimize the plan's provider interactions across Central & Southern Illinois. You will drive network development, provider education, issue resolution, and compliance with Molina policies, while traveling 60%+ to sites and meetings with high-priority providers and health system partners.

The role requires strong communication, training delivery, and collaboration with cross-functional teams to improve

Qualifications

• 6+ years in provider services across Medicaid/Medicare/Marketplace
• Strong understanding of health care delivery systems
• Experience with provider compensation methodologies (FFS, capitation, risk)
• Experience with community agencies and providers
• Strong organizational skills and attention to detail
• Ability to manage multiple tasks and deadlines
• Experience presenting formal presentations
• Strong verbal and written communication skills
• Proficiency with Microsoft Office programs

Responsibilities

• Engage high-priority providers (including value-based and other contracts) to ensure satisfaction and education on Molina initiatives
• Serve as primary contact between Molina and non-complex provider community (FFS, P4P)
• Educate and engage external providers; drive issue resolution, EMR connectivity, and portal adoption
• Resolve complex provider issues crossing multiple departments and leadership
• Conduct regular provider site visits and coordinate schedules to meet site visit goals
• Provide on-the-spot training and counseling while maintaining positive relationships
• Troubleshoot provider problems and proactively resolve issues with the plan
• Lead problem-solving meetings between providers and Molina stakeholders
• Deliver training and presentations to providers and their staff, including large groups
• Promote participation in Molina initiatives (CAHPS, regulatory programs, EDI, EMR, provider portal)
• Monitor and enforce policies to improve provider satisfaction
• Develop and deploy strategic network planning tools
• Collaborate with stakeholders to implement provider services standards
• Navigate matrix teams for new markets and contract support
• Act as a subject matter expert for provider relations
• Mentor and support new provider relations staff
• Role requires 60%+ travel (same-day or overnight)

Skills

Provider relations

Travel readiness

Interpersonal skills

Communication skills

Organizational skills

Tools

Microsoft Office

Job description

Molina Healthcare in Quincy, IL seeks an experienced Provider Relations Specialist to lead and optimize the plan's provider interactions across Central & Southern Illinois. You will drive network development, provider education, issue resolution, and compliance with Molina policies, while traveling 60%+ to sites and meetings with high-priority providers and health system partners.

The role requires strong communication, training delivery, and collaboration with cross-functional teams to improve