Manager, Provider Network Administration (Remote)

Job Description

Job Summary

Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts.

Knowledge / Skills / Abilities

Manages all aspects of the Provider Administration area and serves as contact point for all configuration issues to ensure processes are carried out timely and accurately.

Establishes, maintains and analyzes internal standard operating policies and procedures pertaining to department functions.

Produces reports related to provider network information.

Collaborates with local and corporate departments on issues related to provider loads including, but not limited to, Configuration, Business Systems, Encounters (inbound and outbound), Claims, Provider Services and Contracting.

Identifies issues, resolves problems and implements best practices..

Job Qualifications

Required Education

Bachelor's Degree or equivalent combination of education and experience

Required Experience

5-7 years managed care experience, including min. 2 years of supervisory experience

Min. 2 years health plan Provider Network experience

Required License, Certification, Association

N / A

Preferred Education

Bachelor's Degree

Preferred Experience

7+ years managed care experience

QNXT; SQL experience

Crystal Reports for data extraction

Access and Excel - intermediate plus skill level

Preferred License, Certification, Association

N / A

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.

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Pay Range : $60,415 - $115,000 / ANNUAL

• Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.