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Job Details

Provider Contracts Specialist

Company name
Molina Healthcare, Inc.

Location
Long Beach, CA

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Profile

Provider Contracts Specialist','1801897','US-CA-Long Beach-MOLINA300','','Health Plans','Health Plans','','May 16, 2018','!*!Ideal

candidate will have experience with Medi-Cal / Medicare and quality assurance.

Must be able to multi-task  and excels on

meeting and exceeding deadlines.  Will

have strong contract negotiation skills, including complex contracting, and facility

contracting. 

Must have great presentation and training

abilities, analytical and troubleshooting capabilities. MS Office proficiency.To learn more about Molina Healthcare Careers, follow us on LinkedIn, Twitter & Facebook. You can also visit Molina Cares to view interactive tutorials on resume & cover letter writing, interviewing and more!','!*!Ideal

candidate will have experience with Medi-Cal / Medicare and quality assurance.

Must be able to multi-task  and excels on

meeting and exceeding deadlines.  Will

have strong contract negotiation skills, including complex contracting, and facility

contracting. 

Must have great presentation and training

abilities, analytical and troubleshooting capabilities. MS Office proficiency.To learn more about Molina Healthcare Careers, follow us on LinkedIn, Twitter & Facebook. You can also visit Molina Cares to view interactive tutorials on resume & cover letter writing, interviewing and more!','!*!Job DescriptionJob SummaryResponsible 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/AbilitiesNegotiates 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 templates/amendments.• 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 standards. • Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers. • 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 QualificationsRequired EducationBachelor'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 Experience3 - 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 EducationBachelor's DegreeTo 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.','Provider Contracts Specialist

Company info

Molina Healthcare, Inc.
Website : http://www.molinahealthcare.com

Company Profile
Molina Healthcare, a FORTUNE 500, multi-state health care organization, arranges for the delivery of health care services and offers health information management solutions to nearly five million individuals and families who receive their care through Medicaid, Medicare and other government-funded programs in fifteen states.

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