Specialist, Provider Contracts
Company: Molina Healthcare
Location: Iowa Falls
Posted on: November 25, 2022
JOB DESCRIPTION***Remote and must live in Iowa***Job
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
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
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 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, Des Moines , Specialist, Provider Contracts, Other , Iowa Falls, Iowa
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