Specialist, Provider Contracts
Company: Molina Healthcare
Posted on: January 25, 2023
JOB DESCRIPTION ***Remote and must live in Iowa*** Job Summary
Responsible for accurate and timely maintenance of critical
provider information on all claims and provider databases.
Maintains critical provider information on all claims and provider
databases. Synchronizes data among multiple claims systems and
application of business rules as they apply to each database.
Validate data to be housed on provider databases and ensure
adherence to business and system requirements of customers as it
pertains to contracting, network management and credentialing.
KNOWLEDGE/SKILLS/ABILITIES Negotiates assigned contracts and
letters of agreements with hospitals, physician groups and
ancillary providers that result in high quality, cost effective and
marketable providers. Maintains tracking system and publish reports
according to departmental procedures.
- Initiates, negotiates, generates, and tracks provider Letters
of Agreement, contracts and amendments from initial draft to full
execution utilizing approved standardized contract
- Supports network development throughout state to including
researching, recruiting, and negotiating with providers.
- Participates in the evaluation of provider network and
implementation of strategic plans to meet Molina's network adequacy
- Clearly and professionally communicates contract terms, payment
structures, and reimbursement rates to physician, hospital, and
- Assists in analysis and coordination of amendments,
reimbursement, and language changes. Requests information of
billing codes, services provided and other information needed to
complete the contract profile.
- Coordinates preparation and routing distribution of documents
to complete the contracting process in a timely and thorough manner
according to standardized processes.
- Travels regularly throughout designated regions to meet
targeted needs. JOB QUALIFICATIONS Required Education Bachelor's
Degree or equivalent work experience in health care field
including, but not limited to, provider's office, managed care, or
other health care field. Required Experience 3 - 5 years provider
contract negotiation experience in the health care field including,
but not limited to, provider's office, managed care organization,
or other health care field. Preferred Education Bachelor's Degree
#PJHPO 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. Pay Range: - $19.84 - $38.69 an hour* -
*Actual compensation may vary from posting based on geographic
location, work experience, education and/or skill level
Keywords: Molina Healthcare, Ames , Specialist, Provider Contracts, Other , Ames, Iowa
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