1 month ago
Job Description
Job Description
***Remote and must live in the United States***
JOB DESCRIPTION
Job Summary
Negotiates National agreements with highly visible providers including integrated delivery systems, hospitals and physician groups that result in high quality, cost effective and marketable providers.
KNOWLEDGE/SKILLS/ABILITIES
JOB QUALIFICATIONS
Required Education
Bachelor's Degree in a healthcare related field or an equivalent combination of education and experience.
Required Experience
5-7 years
Preferred Education
Graduate degree
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.
***Remote and must live in the United States***
JOB DESCRIPTION
Job Summary
Negotiates National agreements with highly visible providers including integrated delivery systems, hospitals and physician groups that result in high quality, cost effective and marketable providers.
KNOWLEDGE/SKILLS/ABILITIES
- In conjunction with Director/Manager Provider Contracts, negotiates high priority physician group and facility contracts using Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines.
- Develops and maintains provider contracts in APTTUS contract management software.
- Targets and recruits additional providers to reduce member access grievances.
- Engages targeted contracted providers in renegotiation of rates and/or language. Assists with cost control strategies that positively impact the Medical Care Ratio (MCR) within each region.
- Maintains contractual relationships with significant/highly visible providers.
- Advises Network Provider Contract Coordinators and Specialists on negotiation of individual provider and routine ancillary contracts.
- Evaluates provider network and implement strategic plans with the goal of meeting Molina's network adequacy standards.
- Assesses contract language for compliance with Corporate standards and regulatory requirements and review revised language with assigned MHI attorney.
- Participates in fee schedule determinations including development of new reimbursement models. Seeks input on new reimbursement models from Corporate Network Management and legal.
- Educates internal customers on provider contracts.
- Participates on the management team and other committees addressing the strategic goals of the department and organization.
JOB QUALIFICATIONS
Required Education
Bachelor's Degree in a healthcare related field or an equivalent combination of education and experience.
Required Experience
5-7 years
Preferred Education
Graduate degree
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
Learn More About Molina HealthcareMolina 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
