Manager, Provider Configuration

2 weeks ago


Long Beach, United States Molina Healthcare Full time

**Remote and must live in the United States preferably in the Mountain time zone**

Job Summary

KNOWLEDGE/SKILLS/ABILITIES

Establish and maintain internal standard operating procedures, and enterprise-wide policies and procedures pertaining to Provider functions ensuring alignment with business objectives.

Collaborate with departments on issues related to provider, including but not limited to, Configuration, Business Systems, Encounters (inbound and outbound), Claims, Provider Services and Contracting.

Assist in design and development of new programs as related to transitions and implementations of existing plans with regards to provider data.

Organizational expert in responding to legislative and regulatory developments and audits as it relates to provider information. Supports others in facing out to regulators in developing and implementing appropriate Corrective Action Plans for submission of provider network files, etc.

Act as an expert in handling complaints and other escalated issues from internal customers.

Provider data analysis and claims production management.

Provider Credentialing experience and collaboration with Credentialing process.

JOB QUALIFICATIONS

Required Education

Bachelor's Degree or equivalent combination of education and experience

Required Experience

5-7 years

Preferred Education

Graduate Degree or equivalent combination of education and experience

Preferred Experience

7-9 years

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
**Pay Range**: $72,370.82 - $156,803.45 / ANNUAL
- Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.



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