Provider relations representative Jobs in Houston, TX

Molina Health Plan Network Provider Relations

Molina Health Plan Network Provider Relations 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 Relations staff are the primary point of contact between Molina Healthcare and contracted provider network. They are responsible for network management including provider education, communication, satisfaction, issue intake, access / availability and ensuring knowledge of and compliance with Molina healthcare policies and procedures while achieving the highest level of customer service.

This role serves as the primary point of contact between Molina Health Plan and the non-complex Provider Community that services Molina members, including but not limited to Fee-For-Service and Pay for Performance Providers. It is an external-facing, field-based position requiring a high degree of job knowledge, communication and organizational skills to successfully engage high volume, high visibility providers, including senior leaders and physicians, to ensure provider satisfaction, education on key Molina initiatives, and improved coordination and partnership. Responsibilities include :

• Under minimal direction, works directly with the Plan's external providers to educate, advocate and engage as valuable partners, ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service.
• Conducts regular provider site visits within assigned region / service area.
• Provides on-the-spot training and education as needed.
• Independently troubleshoots problems as they arise.
• Initiates, coordinates and participates in problem-solving meetings between the provider and Molina stakeholders.
• Independently delivers training and presentations to assigned providers and their staff.
• Performs an integral role in network management, by monitoring and enforcing company policies and procedures.
• Trains other Provider Relations Representatives as appropriate.

Role requires 60%+ same-day or overnight travel.

Job Qualifications :

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M / F / D / V. Pay Range : $19.84 - $38.69 / HOURLY Actual compensation may vary from posting based on geographic location, work experience, education and / or skill level.