Provider Contracts Manager

Molina Healthcare • Georgia, Georgia • 2w ago

JOB DESCRIPTION

Job Summary

Negotiates National agreements with highly visible providers 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.

Pay Range: $77,969 - $155,508 / ANNUAL

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

Similar Jobs

Residential Substance Abuse Treatment (RSAT) Manager -Contract- Augusta YDC - Augusta, GA (CCR)

State of Georgia • Georgia, Georgia • 4h ago

Legal & Paralegal

Residential Substance Abuse Treatment (RSAT) Manager -Contract- Augusta YDC - Augusta, GA (CCR) ?? Georgia - Richmond - Augusta ( https://ga.referrals.selectminds.com/jobs/72125/other-jobs-matching/location-only ) New ??...

4h ago

Go to Apply

Substance Use Intervention Counselor-Contract- Wilkes RYDC- Washington, GA (CCR)

State of Georgia • Georgia, Georgia • 4h ago

Legal & Paralegal

Substance Use Intervention Counselor-Contract- Wilkes RYDC- Washington, GA (CCR) ?? Georgia - Wilkes - Washington ( https://ga.referrals.selectminds.com/jobs/72122/other-jobs-matching/location-only ) New ?? ( https://ga....

4h ago

Go to Apply

Attorney, GESA

State of Georgia • Georgia, Georgia • 2d ago

Legal & Paralegal

Attorney, GESA ?? Georgia - Dekalb - Decatur ( https://ga.referrals.selectminds.com/jobs/72052/other-jobs-matching/location-only ) New ?? ( https://ga.referrals.selectminds.com/landingpages/legal-opportunities-at-team-ge...

2d ago

Go to Apply

Contract Management 1

State of Georgia • Georgia, Georgia • 3d ago

Legal & Paralegal

Contract Management 1 ?? Georgia - Fulton - Atlanta ( https://ga.referrals.selectminds.com/jobs/71971/other-jobs-matching/location-only ) New ?? ( https://ga.referrals.selectminds.com/landingpages/financial-opportunities...

3d ago

Go to Apply

Criminal Investigator 3 -Atlanta Farmers Market Investigator

State of Georgia • Georgia, Georgia • 1w ago

Legal & Paralegal

Criminal Investigator 3 -Atlanta Farmers Market Investigator ?? Georgia - Fulton - Atlanta ( https://ga.referrals.selectminds.com/jobs/71862/other-jobs-matching/location-only ) New ?? ( https://ga.referrals.selectminds.c...

1w ago

Go to Apply

Part Time Juvenile Detention Counselor - Gainesville RYDC- Gainesville, GA (CCR)

State of Georgia • Georgia, Georgia • 1w ago

Legal & Paralegal

Part Time Juvenile Detention Counselor - Gainesville RYDC- Gainesville, GA (CCR) ?? Georgia - Hall - Gainesville ( https://ga.referrals.selectminds.com/jobs/71815/other-jobs-matching/location-only ) New ?? ( https://ga.r...

1w ago

Go to Apply

Criminal Investigator 1

State of Georgia • Georgia, Georgia • 1w ago

Legal & Paralegal

Criminal Investigator 1 ?? Georgia - Troup ( https://ga.referrals.selectminds.com/jobs/71726/other-jobs-matching/location-only ) New ? ? 1 additional location Georgia - Troup - LaGrange ?? ( https://ga.referrals.selectmi...

1w ago

Go to Apply

Part Time Juvenile Detention Counselor - Martha K. Glaze RYDC- Hampton, GA (CCR)

State of Georgia • Georgia, Georgia • 2w ago

Legal & Paralegal

Part Time Juvenile Detention Counselor - Martha K. Glaze RYDC- Hampton, GA (CCR) ?? Georgia - Henry - Hampton ( https://ga.referrals.selectminds.com/jobs/71692/other-jobs-matching/location-only ) New ?? ( https://ga.refe...

2w ago

Go to Apply

Paralegal Full Time Instructor- Newton

State of Georgia • Georgia, Georgia • 2w ago

Legal & Paralegal

Paralegal Full Time Instructor- Newton ?? Georgia - Dekalb - Clarkston ( https://ga.referrals.selectminds.com/jobs/71663/other-jobs-matching/location-only ) New ?? ( https://ga.referrals.selectminds.com/landingpages/educ...

2w ago

Go to Apply

Assistant Attorney General -(HOURLY) - CIVIL RIGHTS

State of Georgia • Georgia, Georgia • 2w ago

Legal & Paralegal

Assistant Attorney General -(HOURLY) - CIVIL RIGHTS ?? Georgia - Fulton - Atlanta ( https://ga.referrals.selectminds.com/jobs/71678/other-jobs-matching/location-only ) New ?? ( https://ga.referrals.selectminds.com/landin...

2w ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.