Molina Healthcare

Manager, Provider Network Administration (Remote)

Molina Healthcare$80K — $110K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's Degree or equivalent experience
  • 5-7 years of managed care experience
  • At least 2 years of supervisory experience
  • Minimum 2 years in health plan Provider Network
  • Preferred: 7+ years of managed care experience
  • Preferred: Experience with QNXT and SQL
  • Preferred: Intermediate skills in Access and Excel

Responsibilities

  • Manage all aspects of Provider Administration
  • Establish and analyze standard operating procedures
  • Produce reports related to provider network information
  • Collaborate with local and corporate departments on provider issues
  • Identify issues and implement best practices
  • Resolve problems affecting provider administration

Benefits

  • Competitive benefits and compensation package
  • Equal Opportunity Employer (EOE) status
Full Job Description
Job Description

Job Description
Job Summary
Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts.
Knowledge/Skills/Abilities
• Manages all aspects of the Provider Administration area and serves as contact point for all configuration issues to ensure processes are carried out timely and accurately.
• Establishes, maintains and analyzes internal standard operating policies and procedures pertaining to department functions.
• Produces reports related to provider network information.
• Collaborates with local and corporate departments on issues related to provider loads including, but not limited to, Configuration, Business Systems, Encounters (inbound and outbound), Claims, Provider Services and Contracting.
• Identifies issues, resolves problems and implements best practices..
Job Qualifications

Required Education
Bachelor's Degree or equivalent combination of education and experience
Required Experience
• 5-7 years managed care experience, including min. 2 years of supervisory experience
• Min. 2 years health plan Provider Network experience
Required License, Certification, Association
N/A
Preferred Education
Bachelor's Degree
Preferred Experience
• 7+ years managed care experience
• QNXT; SQL experience
• Crystal Reports for data extraction
• Access and Excel - intermediate plus skill level
Preferred License, Certification, Association
N/A

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

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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