Health Plan Provider Relations Manager - WA ONLY
On-site · Washington, United States
Job Summary
Health Plan Provider Relations Manager responsible for leading provider relations activities within the Molina network in Washington. Oversees network management, provider education, and coordination with high-priority and complex provider communities, including value-based payment contracts. Acts as primary liaison between Molina and contracted providers, ensuring compliance with Molina policies, facilitating provider education, issue resolution, EMR connectivity, and portal adoption. Conducts regular provider site visits, delivers on-the-spot training, troubleshoots provider problems, coordinates problem-solving meetings with senior leadership, and develops strategic planning tools for network management and contracting. Requires extensive travel (80%+), collaboration across multiple departments, and strong presentations and stakeholder management skills.
Required Qualifications
- At least 6 years of provider services experience
- Experience supporting individual/group providers, hospitals, integrated delivery systems, and ancillary providers with Medicaid, Medicare, and/or Marketplace products
- Strong understanding of the health care delivery system
- Experience with managed health care provider compensation methodologies across Medicaid and Medicare lines of business (FFS, capitation, risk, ASO)
- Previous experience with community agencies and providers
- Strong organizational skills and attention to detail
- Ability to manage multiple tasks and deadlines
- Experience with preparing and presenting formal presentations
- Strong interpersonal skills; 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 proficiency
- 80%+ travel (same-day or overnight)
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