Molina Healthcare
Director, Provider Services (Communications/Compliance)
This job is now closed
Job Description
- Req#: 2027225
- Responsible for providing and developing standards and resources to help the Molina health plan successfully develop and refine cost effective and high-quality strategic provider networks, establishing both internal and external long-term partnerships.
- Works collaboratively with health plan network management and operations teams and functional business unit stakeholders to lead and/or support various provider services functions and strategic initiatives with an emphasis on developing and implementing standards, resources, tools and best practices sharing across the organization.
- Provides matrix team support New Markets Provider Onboarding.
- Builds, drafts, and/or performs provider communications, training & education programs for internal staff.
- Ensures compliance with applicable company/plan business requirements including state/federal statutes, government sponsored program requirements, and network access standards.
- 7 years’ experience in managed healthcare administration.
- Experience demonstrating working familiarity with various managed healthcare provider communications, compensation methodologies, primarily across Medicare or Medicaid lines of business, including fee-for service
JOB DESCRIPTION
Job Summary
Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider communications, training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Provider Services staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service.
KNOWLEDGE/SKILLS/ABILITIES
JOB QUALIFICATIONS
Required Education
BA or BS Degree
Required Experience
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
About the company
Molina Healthcare is a managed care company headquartered in Long Beach, California, United States.
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