Molina Healthcare

Manager, Provider Configuration

Molina Healthcare$100K — $130K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • 7+ years in provider data management (PDM) or equivalent education/experience.
  • 1+ year in a management or leadership role.
  • Expertise in data analysis tools and methodologies.
  • Excellent presentation and interpersonal skills for stakeholder engagement.
  • Critical-thinking abilities with a keen eye for detail.
  • Skilled in organization and multitasking under deadlines.
  • Proficiency in Microsoft Office, especially advanced Excel.

Responsibilities

  • Establish and maintain SOPs and policies for provider functions aligning with business goals.
  • Collaborate across departments on provider data management issues.
  • Assist in designing new programs for transitions and implementations.
  • Address legislative and regulatory developments regarding provider info.
  • Manage escalated complaints and issues from internal customers.

Benefits

  • Comprehensive health coverage
  • Retirement savings plan options
  • Flexible working hours
  • Professional development opportunities
  • Employee wellness programs
Full Job Description
Job Description

JOB DESCRIPTION

Job Summary

Leads and manages team responsible for provider data management (PDM) activities including analyzing business processes related to PDM, identifying areas for improvement, and developing and implementing solutions to optimize performance. Ensures accurate and timely maintenance of critical provider information for all claims/provider databases, and application of business rules as it pertains to contracting, network management and credentialing.

Essential Job Duties
• Establishes and maintains internal standard operating procedures (SOPs), and enterprise-wide policies and procedures pertaining to provider functions - ensuring alignment with business objectives.
• Collaborates cross-functionally with departments on issues related to provider data management (PDM) including but not limited to: configuration, business systems, encounters (inbound and outbound), claims, provider services and contracting.
• Assists in design and development of new programs as related to transitions and implementations of existing plans with regards to provider data.
• Responds to legislative and regulatory developments and audits as it relates to provider information; collaborates cross-functionally to interface with regulators to develop and implement appropriate corrective action plans (CAPs) for submission of provider network files, etc.
• Demonstrates expertise in the handling and management of complaints and other escalated issues from internal customers.

Required Qualifications
• At least 7 years of experience in provider data management (PDM), including business analytics experience in health care, or equivalent combination of relevant education and experience.
• At least 1 year management/leadership experience.
• Advanced proficiency in data analysis tools and techniques.
• Strong presentation and interpersonal skills, and ability to interact effectively with stakeholders at all levels.
• Strong critical-thinking skills, and attention to detail.
• Strong organizational and time-management skills; ability to manage simultaneous projects and tasks to meet internal deadlines.
• Strong verbal and written communication skills.
• Microsoft Office suite (including advanced Excel) and applicable software program(s) proficiency.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

About Molina Healthcare

Molina Healthcare focuses exclusively on government-sponsored health care programs for families and individuals who qualify for government-sponsored health care. It contracts with state governments and serves as a health plan, providing a wide range of quality health care services to families and individuals.

Molina Healthcare Careers

Join the dedicated team at Molina Healthcare, a leader in providing quality healthcare services to families and individuals who qualify for government-sponsored programs, including Medicaid and Medicare. As one of the most respected companies in the health services industry, Molina Healthcare offers unparalleled job opportunities aimed at empowering your career growth and professional development.

Work You’ll Do

At Molina Healthcare, you will engage in meaningful work that directly impacts lives across the country. Our team is committed to innovation in healthcare, ensuring that all members receive the best care possible. By joining us, you will collaborate with skilled professionals dedicated to our mission of providing accessible, high-quality healthcare.

Career Opportunities and Growth

Whether you are looking for your first job, seeking a leadership role, or aiming to specialize in healthcare professions, Molina Healthcare offers a range of career paths. Our job opportunities span across various functions, including clinical services, customer support, IT, project management, and more. We believe in fostering the growth of our employees through professional development, leadership training, and diversity initiatives.

Internship Programs

Kickstart your career with a Molina Healthcare internship. Our internships provide invaluable workplace experience, offering a glimpse into the healthcare industry through hands-on projects and mentorship. Interns at Molina Healthcare gain critical skills that prepare them for future employment, making them competitive candidates in the job market.

Culture and Benefits

Molina Healthcare is not just a company; it’s a community. We prioritize a culture of inclusivity and respect, where all team members are encouraged to bring their whole selves to work. Our employees enjoy comprehensive benefits, including health insurance, retirement plans, and wellness programs, all designed to support both their professional and personal lives.

Join Our Team

Explore the various positions available at Molina Healthcare and find where your skills and interests align with our needs. We are continuously hiring talented individuals who are passionate about making a difference in healthcare. Prepare your resume, sharpen your interview skills, and become part of a team that values hard work and creativity.

Stay Connected

Keep up to date with the latest at Molina Healthcare: - **Career Growth and Networking:** Advance your career through our professional development and networking opportunities. Learn from leaders and peers alike to build connections that propel your career forward. - **Innovation and Leadership:** Drive change and lead with confidence by participating in our leadership and innovation training programs.

Apply Now

Ready to take the next step in your healthcare career? Search open positions that match your skills and interests on the Molina Healthcare Jobs portal. We look for driven, curious, and compassionate team players ready to make an impact.

Stay Informed

Subscribe to Molina Healthcare job alerts and receive updates on new openings and company news directly to your inbox. Tailor your subscription to match your career preferences and stay ahead in the dynamic field of healthcare. Join Molina Healthcare, where your career is nurtured, your contributions are valued, and your growth is guaranteed.
Learn more about Molina Healthcare
Size
14,000 employees
Market Cap
$19.5 billion
Industry
Net Income
$673 million
Founded
1980
5 Year Trend
+9.3%
Revenue
$19.4 billion
NASDAQ

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