Health Plan Provider Relations Manager (North Central Florida)
$31,200–$31,200 year
On-siteFlorida, United States or Lafayette, Florida, United States
Job Summary
Manage Molina's health plan provider relations by engaging strategic and non-complex providers, resolving cross-departmental issues, and conducting regular site visits to assess compliance with policies and CMS guidelines. Serve as the primary point of contact for contracted providers, delivering on-the-spot training, facilitating problem-solving meetings, and driving adoption of electronic medical records and portals. Oversee provider satisfaction surveys, develop strategic network planning tools, and mentor team members while navigating a matrix environment. Requires 80%+ same-day or overnight travel.
Required Qualifications
- At least 6 years of provider services experience, including experience supporting individual/group providers, hospitals, integrated delivery systems, and ancillary providers with Medicaid, Medicare, and or Marketplace products, or equivalent combination of relevant education and experience
- Strong understanding of the health care delivery system, including government-sponsored health plans
- Experience with various managed health care provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including: fee-for service (FFS), capitation and various forms of risk, ASO, etc.
- Previous experience with community agencies and providers
- Strong organizational skills and attention to detail
- Ability to manage multiple tasks and deadlines effectively
- Experience with preparing and presenting formal presentations
- Strong interpersonal skills, including ability to interface with providers and medical office staff
- Ability to work in a cross-functional highly matrixed organization
- Strong verbal and written communication skills
- Microsoft Office suite and applicable software programs proficiency
- Role requires 80%+ same-day or overnight travel (extent of same-day or overnight travel will depend on the specific health plan service area)
Desired Qualifications
- Management/leadership experience
- Contract negotiation experience
Hiring someone like this?
Get your role in front of qualified candidates on Sorce.