Molina Healthcare
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Provider Contracts Specialist (LOA's)
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Molina Healthcare Job Summary : Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Job Description : Responsible for contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and JOCs on exception. Executes standardized fee for service and other core payment method contracts with predefined, common programs. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when applicable, and the application of business rules as they apply to each database. Job Duties : This role handles Letters of Agreement (LOA's) with non-complex provider community 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 templates/amendments. 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 standards. Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers. Assists in analysis and coordination of amendments, reimbursement, and language changes. Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes. Participates in other contracting related special projects as directed. Travels regularly throughout designated regions to meet targeted needs. Job Qualifications :
REQUIRED EDUCATION : Associate’s Degree in a related field or an equivalent combination of education and experience.
Required Experience/Knowledge, Skills & Abilities : 2 - 4 years provider contract support or negotiation experience in the health care field. Preferred Education : Bachelor’s Degree in a related field or an equivalent combination of education and experience.
Preferred Experience : 1-3 Years Managed Care experience. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $22.81 - $44.49 / HOURLY.
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Provider Contracts Specialist (LOA's)
role at
Molina Healthcare Job Summary : Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations. Job Description : Responsible for contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and JOCs on exception. Executes standardized fee for service and other core payment method contracts with predefined, common programs. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when applicable, and the application of business rules as they apply to each database. Job Duties : This role handles Letters of Agreement (LOA's) with non-complex provider community 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 templates/amendments. 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 standards. Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers. Assists in analysis and coordination of amendments, reimbursement, and language changes. Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes. Participates in other contracting related special projects as directed. Travels regularly throughout designated regions to meet targeted needs. Job Qualifications :
REQUIRED EDUCATION : Associate’s Degree in a related field or an equivalent combination of education and experience.
Required Experience/Knowledge, Skills & Abilities : 2 - 4 years provider contract support or negotiation experience in the health care field. Preferred Education : Bachelor’s Degree in a related field or an equivalent combination of education and experience.
Preferred Experience : 1-3 Years Managed Care experience. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $22.81 - $44.49 / HOURLY.
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