Director, Provider Contracts (Remote in Iowa)
Company: Molina Healthcare
Location: Des Moines
Posted on: November 25, 2022
KNOWLEDGE/SKILLS/ABILITIESPlans, organizes, staffs, and
coordinates the Provider Contracts activities for the state health
plan. Works with direct management, senior leadership/management,
Corporate, and staff to develop and implement standardized provider
contracts and contracting strategies.
- Monitors and reports network adequacy for Medicare and Medicaid
- In conjunction with direct management and senior leadership,
oversees development of provider contracting strategies,
identifying those specialties and geographic locations on which to
concentrate resources for purposes of establishing a sufficient
network of Participating Providers to serve the health care needs
of members and patients.
- Advises in preparation and negotiations of provider contracts
and oversee negotiation of contracts in concert with established
company guidelines with physicians, hospitals, and other health
- Utilizes standardized contract templates and Pay for
- Develops and maintains Reimbursement Tolerance Parameters
(across multiple specialties/ geographies). Oversees the
development of new reimbursement models in concert with direct
management and senior leadership/management.
- Communicates new strategies to corporate provider network
leadership for input.
- Utilize standardized system(s) to track contract negotiation
activity on an ongoing basis throughout the year.
- Participates on the management team and other committees
addressing the strategic goals of the department and
- Oversees the maintenance of all Provider Contract templates.
Works with Legal and Corporate Network Management as needed to
modify contract templates to ensure compliance with all contractual
and/or regulatory requirements.
- Manages the relationship with area agencies and community
provider partners to support and advance Plan initiatives.
- Develops and implements strategies to comply with state,
federal, NCQA, HEDIS initiatives and regulations.
JOB QUALIFICATIONSRequired EducationBachelor's Degree in a related
field (Business Administration, etc.) or equivalent
- 7+ years' experience in Healthcare Administration, Managed
Care, Provider Contracting and/or Provider Services.
- Min. 2 years' experience managing/supervising employees.
Preferred EducationMaster's DegreePreferred Experience6+ years in
Provider Network contracting#PJCore
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: - $97,298.55 - $189,732.18 a
year**Actual compensation may vary from posting based on geographic
location, work experience, education and/or skill level.
Keywords: Molina Healthcare, Des Moines , Director, Provider Contracts (Remote in Iowa), Executive , Des Moines, Iowa
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