Supervisor, Provider Network Administration

Molina Healthcare, Inc.; Orlando (FL); On-site; USD 50,000 - 97,000; Full time

Job summary

Molina Healthcare, Inc. Tampa, FL area is seeking a senior operations professional to lead a team in provider network administration, validating and maintaining provider data across claims and databases.

You will drive data quality, reporting, and SOP development, ensuring timely updates and educated health plan representatives. This role requires strong leadership, attention to detail, and collaboration with multiple departments.

Qualifications

• 5+ years of health care experience including claims, provider services, or provider network operations.
• Experience with CPT/ICD-9/ICD-10 codes or equivalent knowledge.
• Attention to detail and ability to ensure accurate data entry and delivery.
• Data analysis skills and customer service aptitude.
• Strong verbal and written communication and workflow design experience.

Responsibilities

• Oversees provider network administration activities including updating provider information in systems and reporting.
• Manages data review/analytics to ensure accurate provider demographics and attachments.
• Maintains SOPs and ensures accuracy of provider entries in health plan systems.
• Educates health plan representatives on provider record setup and quality.
• Collaborates across departments to resolve provider data issues and loads.
• Identifies issues, resolves problems, and implements best practices.
• Documents monthly provider network operations meetings and generates required reporting.
• Develops standard reports for audit purposes and supports network administration projects.
• Hires, trains, and evaluates team members with ongoing coaching and development.

Skills

Healthcare experience

Data analysis

Attention to detail

Customer service

Communication skills

Microsoft Excel

Workflow design

Tools

SQL

Microsoft Office

Job description

Tampa, FL, United States and 4 more

Job Description

JOB DESCRIPTION Job Summary

Leads and supervises team responsible for provider network administration activities. Responsible for accurate and timely validation and maintenance of critical provider information on all claims and provider databases, and ensures adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts.

Essential Job Duties

• Oversees responsible for provider network administration (PNA) activities including updating provider-related information in applicable computer system(s), and provider-related reporting, and ensures processes are carried out timely and accurately.
• Oversees provider network data review/analytics/reporting to ensure appropriate information has been provided.
• Maintains department quality standards for provider demographic data with affiliation and fee schedule attachment, and establishes, maintains and analyzes internal standard operating policies (SOPs) and procedures.
• Oversees accuracy of provider entry/information into health plan systems.
• Ensures health plan representatives are educated on appropriate provider record set up.
• Collaborates with local and corporate departments to ensure quality provider demographics are received, and resolve issues related to provider loads including, but not limited to, configuration, business systems, encounters (inbound and outbound), Claims, provider services and contracting.
• Identifies PNA issues, resolves problems and implements best practices.
• Conducts and documents monthly provider network administration operational meetings.
• Generates required PNA reporting for leaders and applicable stakeholders.
• Collaborates cross-functionally to develop standard reports for audit purposes.
• Provides support for provider network administration projects.
• Hires, trains, manages and evaluates team member performance - provides coaching, development, and recognition; ensures ongoing appropriate staff training, holds regular team meetings, and drives communication and collaboration.

Required Qualifications

• At least 5 years of health care experience, to include experience in claims, provider services, provider network operations, and/or hospital/physician billing, and at least 3 years of experience with medical terminology, Current Procedural Terminology (CPT), International Classification of Disease (ICD-9/ICD-10) codes, or equivalent combination of relevant education and experience.
• Claims processing experience, including coordination of benefits (COB), subrogation, and/or eligibility criteria.
• Attention to detail, and ability to facilitate accurate data entry/review/delivery.
• Data analysis skills.
• Customer service skills.
• Ability to manage multiple priorities and meet deadlines.
• Workflow design experience.
• Effective verbal and written communication skills.
• Microsoft Office suite proficiency (including intermediate Excel skills), and applicable software programs proficiency.

Preferred Qualifications

• Management/leadership experience.
• Query language experience.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Job Info

• Job Identification 2039722
• Job Category Operations
• Posting Date 10/21/2026, 06:55 PM
• Job Schedule Full time
• Locations Tampa, FL, United States FL, United States Orlando, FL, United States Jacksonville, FL, United States Tallahassee, FL, United States
• Salary Range $49,930.00 - $97,363.00 Annually *Actual compensation may vary based on geographic location, work experience, education and/or skill level