2025-09-16
Molina Healthcare (https://careers.molinahealthcare.com/)
Other
/yr
full-time
employee
Georgia
United States
***Remote and must live in Georgia***
Job Description
Knowledge/Skills/Abilities
• Plans, organizes, staffs, and coordinates the Provider Contracts activities for contracts. 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 to leadership for all lines of business when leading or assisting with a new market campaign or expansion.
• In conjunction with direct management and senior leadership, for new builds collaborates with Business Development to determine provider contracting strategies, and for new builds and expansions identifies 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 care providers.
• Utilizes standardized contract templates and the PADU process.
• Collaborates with the Value Based Care team to understand new value-based care programs and provider targets.
• 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 until contract implementation is complete.
• Participates on committees addressing the strategic goals of the department and organization.
• Works with Legal and Corporate Network Management as needed to modify contract templates to ensure compliance with all contractual and/or regulatory requirements as Molina expands its footprint for all lines of business.
• Establishes, nurtures and manages relationships with area agencies, community provider partners and local Molina staff to support and advance Plan initiatives.
Job Qualifications
REQUIRED EDUCATION:
Bachelor's Degree in a related field (Business Administration, etc.) or equivalent experience.
REQUIRED EXPERIENCE:
7+ years’ experience in Healthcare Administration, Managed Care, Provider Contracting and/or Provider Services.
PREFERRED EDUCATION:
Master's Degree
PREFERRED EXPERIENCE:
6+ years in Provider Network contracting
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.
#PJCorp
Pay Range: $97,299 - $189,732 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
