Provider Contracts Manager job vacancy in Molina Healthcare – Jobs in California

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We got a new job details in Molina Healthcare & they are Hiring Candidates for Provider Contracts Manager

Job Details
Company Name : Molina Healthcare
Company Location : Long Beach, CA 90802
Job Position : Provider Contracts Manager
Job Category : Jobs in California

Job Description :
JOB DESCRIPTION

Job Summary

Negotiates agreements with highly visible providers who are strategic to the success of the Plan, 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.