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Provider Jobs in Detroit, MI

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Last updated: 1 day ago
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Senior Representative, Provider Services

Senior Representative, Provider Services

Detroit StaffingDetroit, MI, US
Full-time
Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare...Show moreLast updated: 30+ days ago
Provider Capacity Analyst

Provider Capacity Analyst

Columbia UniversityColumbia University Medical Center
Full-time
Reporting to the Template Team Manager, the Provider Capacity Analyst will provide consultative support to clinical practices on provider capacity and template configuration.The analyst will work w...Show moreLast updated: 30+ days ago
  • Promoted
Specialist, Provider Licensing & Credentialing

Specialist, Provider Licensing & Credentialing

Thirty MadisonDetroit, MI, US
Full-time
Specialist, Provider Licensing & Credentialing.As a Specialist for the Provider Licensing & Credentialing, you will work closely with our providers and business stakeholders to support the Keeps Me...Show moreLast updated: 30+ days ago
Provider Enrollment Analyst / Credentialing

Provider Enrollment Analyst / Credentialing

WPS Health SolutionsDetroit, MI, United States
Full-time
The Provider Enrollment Analyst will approve, deny, or return applications submitted by Medicare providers.This work is important in helping providers enroll in the Medicare program.Weeks) : Monday ...Show moreLast updated: 12 days ago
  • Promoted
Opinion Provider (Work from Home)

Opinion Provider (Work from Home)

IpsosGrosse Pointe Shores, Michigan, United States
Remote
Full-time
Ipsos iSay, an online research community powered by Ipsos—the world’s third-largest market research company—is looking for enthusiastic. This is your opportunity to influence the future of brands, g...Show moreLast updated: 8 days ago
Senior Representative, Provider Services

Senior Representative, Provider Services

Molina HealthcareDetroit, MI, United States
Full-time
JOB DESCRIPTION • • • •Job Summary • • Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education,...Show moreLast updated: 30+ days ago
  • Promoted
Provider Network Operations Data Analyst

Provider Network Operations Data Analyst

AmeriHealth CaritasDetroit, MI, US
Full-time
Job Title : Provider Network Operations Data Analyst.Role Overview : The Provider Network Operations Data Analyst plays a key role in maintaining accurate provider data and fostering strong relations...Show moreLast updated: 26 days ago
  • Promoted
Advanced Practice Provider - Crisis CT

Advanced Practice Provider - Crisis CT

Detroit Wayne Mental Health AuthorityDetroit, MI, United States
Full-time
Advanced Practice Provider (Psychiatric Nurse Practitioner / Physician Assistant).Under the general supervision of the Medical Director of Crisis Services, the Advanced Practice Provider (Nurse Pract...Show moreLast updated: 30+ days ago
  • Promoted
Provider Partnerships Manager (Territory Sales Manager)

Provider Partnerships Manager (Territory Sales Manager)

NourishDetroit, MI, US
Full-time
Nourish is on a mission to improve people's health by making it easy to eat well.Nutrition-related chronic disease is the largest and most overlooked crisis in the world.Food can be medicine : w...Show moreLast updated: 30+ days ago
  • Promoted
Advanced Practice Provider (PA)

Advanced Practice Provider (PA)

MyCareer+Hamtramck, Michigan, USA
Full-time
Advanced Practice Provider ( PA).Were on a mission to deliver uncompromising healthcare that transforms livesone patient one experience at a time. As part of our multi-specialty practice we focus on...Show moreLast updated: 19 days ago
Provider Network Manager

Provider Network Manager

Detroit Wayne Integrated Health NetworkDetroit, Michigan, United States, 48202
Full-time
Under the supervision of the Director of Managed Care Operations, the Provider Network Manager is responsible for the overall coordination of the contracts between the Detroit Wayne Integrated Heal...Show moreLast updated: 30+ days ago
Elder Care Provider

Elder Care Provider

ElderCare.comDetroit, Michigan, USA
Full-time
We are the Shirmarrick family, located in Detroit, Michigan, and we are currently seeking a dedicated, full-time elder care provider. This is a live-out position offering comprehensive home care ser...Show moreLast updated: 30+ days ago
  • Promoted
Manager, Provider Partnerships | Detroit, MI

Manager, Provider Partnerships | Detroit, MI

TalkiatryDetroit, MI, US
Full-time
Manager, Provider Partnerships | Detroit, MI.We are hiring a field-based Provider Partnerships Manager who thrives on building relationships in medical settings, driving growth, and helping practic...Show moreLast updated: 10 days ago
NP / PA / PT : Wound Care Provider

NP / PA / PT : Wound Care Provider

Skilled Wound ExpertsDetroit, MI, US
Full-time
The Wound Care Clinical Provider will be responsible for providing wound management for wounds while closely collaborating with the facility wound nurse and nursing team. Clinician will provide spec...Show moreLast updated: 9 days ago
  • Promoted
Special Project Lead (Provider Enablement)

Special Project Lead (Provider Enablement)

Clover HealthDetroit, MI, US
Full-time
Special Project Lead (Provider Enablement).The Clover Care Services organization delivers proactive support and care to our members through our Clover Home Care teams, and quality improvement servi...Show moreLast updated: 29 days ago
Provider Operations Revenue Cycle Consultant, Manager

Provider Operations Revenue Cycle Consultant, Manager

PwCDetroit, MI, United States
Full-time
Industry / Sector Health Services Specialism Operations Management Level Manager Job Description & Summary At PwC, our people in operations consulting specialise in providing consulting servic...Show moreLast updated: 1 day ago
  • Promoted
Nurse Practitioner - NP / Advanced Practice Provider

Nurse Practitioner - NP / Advanced Practice Provider

MLee Healthcare Staffing and Recruiting, IncDetroit, MI, United States
Full-time
Embrace Compassion, Practice Autonomy - Your Next Opportunity as a Nurse Practitioner Awaits in the Vibrant City of Detroit. Within the realm of healthcare, your impact is evident not just through s...Show moreLast updated: 9 days ago
  • Promoted
Engineering Manager (Provider Growth)

Engineering Manager (Provider Growth)

HeadwayDetroit, MI, US
Full-time
Engineering Manager (Provider Growth).Headway's mission is to build a new mental health care system everyone can access.We've built technology that helps people find great therapists with the first...Show moreLast updated: 30+ days ago
  • Promoted
Hybrid APC Provider- Detroit, Michigan

Hybrid APC Provider- Detroit, Michigan

CityblockDetroit, MI, United States
Full-time
The Pod Provider delivers comprehensive chronic disease management (e.The role works collaboratively with an interdisciplinary team of clinical and non-clinical members to develop member care plans...Show moreLast updated: 9 days ago
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Senior Representative, Provider Services

Senior Representative, Provider Services

Detroit StaffingDetroit, MI, US
30+ days ago
Job type
  • Full-time
Job description

Job Summary

Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state, and local regulations. Provider Services staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for the provider training, network management and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service.

Knowledge / Skills / Abilities :

  • Under general supervision, responsible for various provider services functions with an emphasis on working externally with the Plan's highest priority, high volume, strategic providers to educate, advocate and engage as valuable partners.
  • Requires an in-depth knowledge of provider services and contracting subject matter expertise.
  • Resolves complex provider issues that may cross departmental lines and involve Senior Leadership.
  • Serves as a subject matter expert for other departments.
  • Trains other Provider Services Representatives, as appropriate.

Job Qualifications :

Required Education : Bachelor's Degree or equivalent provider contract, network development and management, or project management experience in a managed healthcare setting.

Required Experience :

  • 3 - 5 years customer service, provider service, or claims experience in a managed care setting.
  • 3-5 years' experience in managed healthcare administration and / or Provider Services.
  • 5 years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc.
  • Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to; fee-for service, capitation, and various forms of risk, ASO, etc.
  • Preferred Education : Bachelor's or master's degree.

    Preferred Experience :

  • 5+ years' experience in managed healthcare administration and / or Provider Services.
  • 5+ years' experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e., physician, group and hospital contracting, etc.
  • 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 - $116,835 / ANNUAL

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