Representative, Dental Provider Services

Job Summary

Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider 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 :

• Under minimal direction, works directly with the Plan's external providers to educate, advocate, and engage as valuable partners, ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service.
• Conducts regular provider site visits within assigned region / service area.
• Provides on-the-spot training and education as needed.
• Independently troubleshoots problems as they arise.
• Initiates, coordinates, and participates in problem-solving meetings.
• Independently delivers training and presentations to assigned providers.
• Performs an integral role in network management.
• Trains other Provider Services Representatives as appropriate.
• Role requires 80%+ same-day or overnight travel.

Job Qualifications :

Required Education : Bachelor's Degree or equivalent provider contract, network development and management, or project management experience in a managed healthcare setting.

Required Experience : 2 - 3 years customer service, provider service, or claims experience in a managed care setting. Working familiarity with various managed healthcare provider compensation methodologies.

Preferred Education : Bachelor's Degree.

Preferred Experience : 5 years' experience in managed healthcare administration and / or Provider Services. 5 years' experience in provider contract negotiations in a managed healthcare setting.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M / F / D / V. Pay Range : $21.16 - $46.42 / HOURLY Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.