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Senior Provider Relations Representative
2 months ago
Molina Healthcare is seeking a highly skilled Provider Relations Specialist to join our team. As a key member of our network development team, you will be responsible for building and maintaining strong relationships with healthcare providers, ensuring seamless network management and optimal patient care.
Key Responsibilities- Develop and implement effective provider relations strategies to drive network growth and satisfaction.
- Collaborate with healthcare providers to educate them on Molina Healthcare's policies, procedures, and initiatives.
- Conduct regular site visits to assess provider compliance with Molina Healthcare's standards and identify areas for improvement.
- Provide on-the-spot training and education to providers and their staff, addressing complex issues and concerns.
- Initiate and coordinate problem-solving meetings between providers and Molina Healthcare stakeholders to resolve issues and improve network performance.
- Deliver training and presentations to providers and their staff on various topics, including administrative cost effectiveness, member satisfaction, and regulatory compliance.
- Monitor and enforce company policies and procedures, ensuring compliance with regulatory requirements.
- Train and mentor other Provider Relations Specialists to enhance their skills and knowledge.
- Bachelor's degree in a related field, such as healthcare administration or business.
- 3-5 years of experience in customer service, provider relations, or claims management in a managed care setting.
- Working familiarity with various managed healthcare provider compensation methodologies, including fee-for-service, capitation, and risk-based models.
- Excellent communication, negotiation, and problem-solving skills.
- Ability to work independently and as part of a team, with a strong focus on customer service and provider satisfaction.
Molina Healthcare is a nationwide fortune 500 organization dedicated to providing quality healthcare to people receiving government assistance. We offer a competitive benefits and compensation package, as well as opportunities for professional growth and development.
