Contracts Specialist jobs at HCA Healthcare

Responsible for the strategic development and administration of contracts with State and/or Federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations. **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for coordinating, conducting and/or responding to research requests pertaining to government healthcare programs; preparing and submitting regulatory reports for filings; reviewing Plan submissions for quality, accuracy, and timeliness; and ensuring Plan meets contractual and regulatory requirements. + Reviews Provider Agreement, EOC/ Member Handbook, Provider Directory, marketing materials, and other contract reporting deliverables for compliance with contractual and regulatory requirements prior to submission. + Assesses information received from government contracting agencies and regulators and disseminates to impacted Plan staff. + Participates in meetings related to Molina government run programs with State agencies and Molina Corporate departments and disseminates relevant information to staff and management. + Oversees/maintains the department's documentation and archive system, ensuring submitted reports are archived for historical and audit purposes. Ensures system is updated and complete. + Conduct research, interpret, and analyze federal law, rules and regulations as needed to provide guidance, support, and/or direction to internal staff. + Serve as liaison between the department and the organization's business owners/leaders and its staff members. + Assist in maintaining the Operational Review Audit Readiness folders annually and consistently monitor for regulatory changes that could affect operations, particularly contract compliance and audit preparedness. + Support business owners in the preparation of the AHCCCS triannual Operational Review. + Assist in project managing contract implementation, amendments, and state policy changes. + Accountable for the logging, tracking, analysis, follow-up, and reporting of contract deliverables, and for ensuring the system and dashboard remain current. + Responsibilities encompass managing contract deliverables, resubmissions, rejections, inquiries, complaints, internal incidents, disclosures, marketing and member information materials, regulatory requirements, policy updates, annual policy and procedure reviews in collaboration with the Policy Committee, as well as coordinating meetings with the regulatory agency. + Other duties as assigned. **JOB QUALIFICATIONS** **Required Education** High School diploma or equivalent **Required Experience** + 3 years' experience in a managed care environment. + Experience demonstrating strong: communication and presentation skills; analytical/reasoning ability; detail orientation; organizational and interpersonal skills. + Proficient in compiling data, creating reports, and presenting information, using Crystal Reports (or similar reporting tools), SQL query, MS Access, and MS Excel. **Preferred Education** Bachelor's Degree in Business Administration, Healthcare, or related field. 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: $45,390 - $88,511.46 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

The Payment Compliance & Contract Management Specialist (PCCM Specialist) serves as a subject matter expert and team lead, responsible for maximizing reimbursement through the identification of revenue opportunities and resolution of contractual variances. This role oversees quality assurance and performance management processes, providing guidance to team members and allocating workloads effectively. This role also involves analyzing reimbursement discrepancies, providing strategic insights, and collaborating with internal and external stakeholders to improve revenue cycle processes. As a Payment Compliance & Contract Management Specialist (PCCM Specialist) at Community Health Systems (CHS) - PCCM, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including medical, dental and vision, insurance, and 401k. Essential Functions * Conducts quality monitoring to ensure team performance meets departmental metrics, and provides actionable recommendations to senior leadership when KPIs are not achieved. * Trains and mentors staff to ensure team efficiency and compliance with departmental standards. * Manages, maintains, and directs key technologies administered by the department to support payment compliance and contract management activities. * Analyzes workload demands through data analysis, assigning tasks to team members based on priorities and department needs. * Identifies opportunities for process improvement and collaborates with external organizations to enhance payment integrity and optimize contract modeling. * Performs other duties as assigned. * Complies with all policies and standards. * This is a fully remote opportunity. Qualifications * Bachelor's Degree or equivalent work experience on a year-for-year basis required * 3-5 years of experience in healthcare reimbursement, contract management, or revenue cycle operations required * Demonstrated expertise in analyzing and interpreting payer contracts and reimbursement methodologies required * Experience working with insurance payor contracts stronly preferred. Knowledge, Skills and Abilities * Strong analytical and data interpretation skills. * Advanced understanding of healthcare reimbursement systems and payer contracts. * Excellent leadership and team collaboration abilities. * Effective communication and presentation skills. * Proficiency in data analysis tools and healthcare billing software. * High attention to detail and ability to manage multiple priorities. We know it's not just about finding a job. It's about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible. The Payment Compliance and Contract Management (PCCM) team plays a critical role in ensuring that payments are made according to contractual agreements and regulatory requirements. The team oversees the full contract lifecycle, focusing on analyzing reimbursement discrepancies, improving revenue cycle processes, and ensuring compliance with contract terms to support financial accuracy and operational efficiency. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.

The Payment Compliance & Contract Management Specialist (PCCM Specialist) serves as a subject matter expert and team lead, responsible for maximizing reimbursement through the identification of revenue opportunities and resolution of contractual variances. This role oversees quality assurance and performance management processes, providing guidance to team members and allocating workloads effectively. This role also involves analyzing reimbursement discrepancies, providing strategic insights, and collaborating with internal and external stakeholders to improve revenue cycle processes. As a Payment Compliance & Contract Management Specialist (PCCM Specialist) at Community Health Systems (CHS) - PCCM, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including medical, dental and vision, insurance, and 401k. Essential Functions Conducts quality monitoring to ensure team performance meets departmental metrics, and provides actionable recommendations to senior leadership when KPIs are not achieved. Trains and mentors staff to ensure team efficiency and compliance with departmental standards. Manages, maintains, and directs key technologies administered by the department to support payment compliance and contract management activities. Analyzes workload demands through data analysis, assigning tasks to team members based on priorities and department needs. Identifies opportunities for process improvement and collaborates with external organizations to enhance payment integrity and optimize contract modeling. Performs other duties as assigned. Complies with all policies and standards. This is a fully remote opportunity. Qualifications Bachelor's Degree or equivalent work experience on a year-for-year basis required 3-5 years of experience in healthcare reimbursement, contract management, or revenue cycle operations required Demonstrated expertise in analyzing and interpreting payer contracts and reimbursement methodologies required Experience working with insurance payor contracts stronly preferred. Knowledge, Skills and Abilities Strong analytical and data interpretation skills. Advanced understanding of healthcare reimbursement systems and payer contracts. Excellent leadership and team collaboration abilities. Effective communication and presentation skills. Proficiency in data analysis tools and healthcare billing software. High attention to detail and ability to manage multiple priorities. We know it's not just about finding a job. It's about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible. The Payment Compliance and Contract Management (PCCM) team plays a critical role in ensuring that payments are made according to contractual agreements and regulatory requirements. The team oversees the full contract lifecycle, focusing on analyzing reimbursement discrepancies, improving revenue cycle processes, and ensuring compliance with contract terms to support financial accuracy and operational efficiency. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.

The Payment Compliance & Contract Management Specialist (PCCM Specialist) serves as a subject matter expert and team lead, responsible for maximizing reimbursement through the identification of revenue opportunities and resolution of contractual variances. This role oversees quality assurance and performance management processes, providing guidance to team members and allocating workloads effectively. This role also involves analyzing reimbursement discrepancies, providing strategic insights, and collaborating with internal and external stakeholders to improve revenue cycle processes. As a Payment Compliance & Contract Management Specialist (PCCM Specialist) at Community Health Systems (CHS) - PCCM, you'll play a vital role in supporting our purpose to help people get well and live healthier by providing safe, quality healthcare, building enduring relationships with our patients, and providing value for the people and communities we serve. Our team members enjoy a robust benefits package including medical, dental and vision, insurance, and 401k. **Essential Functions** + Conducts quality monitoring to ensure team performance meets departmental metrics, and provides actionable recommendations to senior leadership when KPIs are not achieved. + Trains and mentors staff to ensure team efficiency and compliance with departmental standards. + Manages, maintains, and directs key technologies administered by the department to support payment compliance and contract management activities. + Analyzes workload demands through data analysis, assigning tasks to team members based on priorities and department needs. + Identifies opportunities for process improvement and collaborates with external organizations to enhance payment integrity and optimize contract modeling. + Performs other duties as assigned. + Complies with all policies and standards. + **This is a fully remote opportunity.** **Qualifications** + Bachelor's Degree or equivalent work experience on a year-for-year basis required + 3-5 years of experience in healthcare reimbursement, contract management, or revenue cycle operations required + Demonstrated expertise in analyzing and interpreting payer contracts and reimbursement methodologies required + Experience working with insurance payor contracts stronly preferred. **Knowledge, Skills and Abilities** + Strong analytical and data interpretation skills. + Advanced understanding of healthcare reimbursement systems and payer contracts. + Excellent leadership and team collaboration abilities. + Effective communication and presentation skills. + Proficiency in data analysis tools and healthcare billing software. + High attention to detail and ability to manage multiple priorities. We know it's not just about finding a job. It's about finding a place where you are respected, valued and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible. The Payment Compliance and Contract Management (PCCM) team plays a critical role in ensuring that payments are made according to contractual agreements and regulatory requirements. The team oversees the full contract lifecycle, focusing on analyzing reimbursement discrepancies, improving revenue cycle processes, and ensuring compliance with contract terms to support financial accuracy and operational efficiency. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 71 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers. Equal Employment Opportunity This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment. This applies to all terms and conditions of employment including, but not limited to: hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. If you are an applicant with a mental or physical disability who needs a reasonable accommodation for any part of the application or hiring process, contact the director of Human Resources at the facility to which you are seeking employment; Simply go to ************************************************* to obtain the main telephone number of the facility and ask for Human Resources.

Responsible for the strategic development and administration of contracts with State and/or Federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations. **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for coordinating, conducting and/or responding to research requests pertaining to government healthcare programs; preparing and submitting regulatory reports for filings; reviewing Plan submissions for quality, accuracy, and timeliness; and ensuring Plan meets contractual and regulatory requirements. + Reviews Provider Agreement, EOC/ Member Handbook, Provider Directory, marketing materials, and other contract reporting deliverables for compliance with contractual and regulatory requirements prior to submission. + Assesses information received from government contracting agencies and regulators and disseminates to impacted Plan staff. + Participates in meetings related to Molina government run programs with State agencies and Molina Corporate departments and disseminates relevant information to staff and management. + Oversees/maintains the department's documentation and archive system, ensuring submitted reports are archived for historical and audit purposes. Ensures system is updated and complete. + Conduct research, interpret, and analyze federal law, rules and regulations as needed to provide guidance, support, and/or direction to internal staff. + Serve as liaison between the department and the organization's business owners/leaders and its staff members. + Assist in maintaining the Operational Review Audit Readiness folders annually and consistently monitor for regulatory changes that could affect operations, particularly contract compliance and audit preparedness. + Support business owners in the preparation of the AHCCCS triannual Operational Review. + Assist in project managing contract implementation, amendments, and state policy changes. + Accountable for the logging, tracking, analysis, follow-up, and reporting of contract deliverables, and for ensuring the system and dashboard remain current. + Responsibilities encompass managing contract deliverables, resubmissions, rejections, inquiries, complaints, internal incidents, disclosures, marketing and member information materials, regulatory requirements, policy updates, annual policy and procedure reviews in collaboration with the Policy Committee, as well as coordinating meetings with the regulatory agency. + Other duties as assigned. **JOB QUALIFICATIONS** **Required Education** High School diploma or equivalent **Required Experience** + 3 years' experience in a managed care environment. + Experience demonstrating strong: communication and presentation skills; analytical/reasoning ability; detail orientation; organizational and interpersonal skills. + Proficient in compiling data, creating reports, and presenting information, using Crystal Reports (or similar reporting tools), SQL query, MS Access, and MS Excel. **Preferred Education** Bachelor's Degree in Business Administration, Healthcare, or related field. 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: $45,390 - $88,511.46 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Responsible for the strategic development and administration of contracts with State and/or Federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations. **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for coordinating, conducting and/or responding to research requests pertaining to government healthcare programs; preparing and submitting regulatory reports for filings; reviewing Plan submissions for quality, accuracy, and timeliness; and ensuring Plan meets contractual and regulatory requirements. + Reviews Provider Agreement, EOC/ Member Handbook, Provider Directory, marketing materials, and other contract reporting deliverables for compliance with contractual and regulatory requirements prior to submission. + Assesses information received from government contracting agencies and regulators and disseminates to impacted Plan staff. + Participates in meetings related to Molina government run programs with State agencies and Molina Corporate departments and disseminates relevant information to staff and management. + Oversees/maintains the department's documentation and archive system, ensuring submitted reports are archived for historical and audit purposes. Ensures system is updated and complete. + Conduct research, interpret, and analyze federal law, rules and regulations as needed to provide guidance, support, and/or direction to internal staff. + Serve as liaison between the department and the organization's business owners/leaders and its staff members. + Assist in maintaining the Operational Review Audit Readiness folders annually and consistently monitor for regulatory changes that could affect operations, particularly contract compliance and audit preparedness. + Support business owners in the preparation of the AHCCCS triannual Operational Review. + Assist in project managing contract implementation, amendments, and state policy changes. + Accountable for the logging, tracking, analysis, follow-up, and reporting of contract deliverables, and for ensuring the system and dashboard remain current. + Responsibilities encompass managing contract deliverables, resubmissions, rejections, inquiries, complaints, internal incidents, disclosures, marketing and member information materials, regulatory requirements, policy updates, annual policy and procedure reviews in collaboration with the Policy Committee, as well as coordinating meetings with the regulatory agency. + Other duties as assigned. **JOB QUALIFICATIONS** **Required Education** High School diploma or equivalent **Required Experience** + 3 years' experience in a managed care environment. + Experience demonstrating strong: communication and presentation skills; analytical/reasoning ability; detail orientation; organizational and interpersonal skills. + Proficient in compiling data, creating reports, and presenting information, using Crystal Reports (or similar reporting tools), SQL query, MS Access, and MS Excel. **Preferred Education** Bachelor's Degree in Business Administration, Healthcare, or related field. 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: $45,390 - $88,511.46 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to financial 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. Responsible for accurate and timely maintenance of Value Based Contracts (VBCs) post execution, including but not limited to, data analysis and reporting that ensures VBCs fulfill APM provider payment and regulatory requirements related to state-mandated value-based programs. Supports Manager with contracting/re-contracting of VBCs, issue escalations and JOCs on exception. Synchronizes data among multiple systems when applicable and ensures adherence to business and system requirements of customers as it pertains to contracting and network management. **Job Duties** This role supports assigned contracts with VBC providers that result in high quality and cost-effective care. Maintains tracking system and publishes reports according to departmental procedures. Contracting/re-contracting of VBCs, issue escalations and Joint Operating Committees on exception. - Assists Manager and/or Director in the negotiation of medical group/IPA and hospital VBC contracting. - Serves as VBC regulatory data and reporting lead by developing and producing as required to engage with provider and facilitate VBC performance. - Supports VBC network throughout the state to include onboarding VBC providers and supporting JOC's. - Clearly and professionally communicates VBC contract terms to VBC providers. - Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes. - Communicates proactively with other departments to ensure effective and efficient business results. - Trains and monitors newly hired Contract Specialist(s). - Participates in other VBC related special projects as directed. - Limited team travel once to twice annually. **Job Qualifications** **REQUIRED EDUCATION:** Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** - 4-6 years' previous experience in contracting with large specialty or multispecialty provider groups. - 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Provider facing experience and knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) highly desirable. Experience generating financial reporting to meet regulatory requirements. Ohio based candidate desired; however, not required. Pay Range: $30.37 - $61.79 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to financial 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. Responsible for accurate and timely maintenance of Value Based Contracts (VBCs) post execution, including but not limited to, data analysis and reporting that ensures VBCs fulfill APM provider payment and regulatory requirements related to state-mandated value-based programs. Supports Manager with contracting/re-contracting of VBCs, issue escalations and JOCs on exception. Synchronizes data among multiple systems when applicable and ensures adherence to business and system requirements of customers as it pertains to contracting and network management. Job Duties This role supports assigned contracts with VBC providers that result in high quality and cost-effective care. Maintains tracking system and publishes reports according to departmental procedures. Contracting/re-contracting of VBCs, issue escalations and Joint Operating Committees on exception. * Assists Manager and/or Director in the negotiation of medical group/IPA and hospital VBC contracting. * Serves as VBC regulatory data and reporting lead by developing and producing as required to engage with provider and facilitate VBC performance. * Supports VBC network throughout the state to include onboarding VBC providers and supporting JOC's. * Clearly and professionally communicates VBC contract terms to VBC providers. * Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes. * Communicates proactively with other departments to ensure effective and efficient business results. * Trains and monitors newly hired Contract Specialist(s). * Participates in other VBC related special projects as directed. * Limited team travel once to twice annually. Job Qualifications REQUIRED EDUCATION: Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field. REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: * 4-6 years' previous experience in contracting with large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience PREFERRED EXPERIENCE: Provider facing experience and knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) highly desirable. Experience generating financial reporting to meet regulatory requirements. Ohio based candidate desired; however, not required. Pay Range: $30.37 - $61.79 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Responsible for the strategic development and administration of contracts with State and/or Federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations. **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for coordinating, conducting and/or responding to research requests pertaining to government healthcare programs; preparing and submitting regulatory reports for filings; reviewing Plan submissions for quality, accuracy, and timeliness; and ensuring Plan meets contractual and regulatory requirements. + Reviews Provider Agreement, EOC/ Member Handbook, Provider Directory, marketing materials, and other contract reporting deliverables for compliance with contractual and regulatory requirements prior to submission. + Assesses information received from government contracting agencies and regulators and disseminates to impacted Plan staff. + Participates in meetings related to Molina government run programs with State agencies and Molina Corporate departments and disseminates relevant information to staff and management. + Oversees/maintains the department's documentation and archive system, ensuring submitted reports are archived for historical and audit purposes. Ensures system is updated and complete. + Conduct research, interpret, and analyze federal law, rules and regulations as needed to provide guidance, support, and/or direction to internal staff. + Serve as liaison between the department and the organization's business owners/leaders and its staff members. + Assist in maintaining the Operational Review Audit Readiness folders annually and consistently monitor for regulatory changes that could affect operations, particularly contract compliance and audit preparedness. + Support business owners in the preparation of the AHCCCS triannual Operational Review. + Assist in project managing contract implementation, amendments, and state policy changes. + Accountable for the logging, tracking, analysis, follow-up, and reporting of contract deliverables, and for ensuring the system and dashboard remain current. + Responsibilities encompass managing contract deliverables, resubmissions, rejections, inquiries, complaints, internal incidents, disclosures, marketing and member information materials, regulatory requirements, policy updates, annual policy and procedure reviews in collaboration with the Policy Committee, as well as coordinating meetings with the regulatory agency. + Other duties as assigned. **JOB QUALIFICATIONS** **Required Education** High School diploma or equivalent **Required Experience** + 3 years' experience in a managed care environment. + Experience demonstrating strong: communication and presentation skills; analytical/reasoning ability; detail orientation; organizational and interpersonal skills. + Proficient in compiling data, creating reports, and presenting information, using Crystal Reports (or similar reporting tools), SQL query, MS Access, and MS Excel. **Preferred Education** Bachelor's Degree in Business Administration, Healthcare, or related field. 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: $45,390 - $88,511.46 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to financial 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. Responsible for accurate and timely maintenance of Value Based Contracts (VBCs) post execution, including but not limited to, data analysis and reporting that ensures VBCs fulfill APM provider payment and regulatory requirements related to state-mandated value-based programs. Supports Manager with contracting/re-contracting of VBCs, issue escalations and JOCs on exception. Synchronizes data among multiple systems when applicable and ensures adherence to business and system requirements of customers as it pertains to contracting and network management. Job Duties This role supports assigned contracts with VBC providers that result in high quality and cost-effective care. Maintains tracking system and publishes reports according to departmental procedures. Contracting/re-contracting of VBCs, issue escalations and Joint Operating Committees on exception. • Assists Manager and/or Director in the negotiation of medical group/IPA and hospital VBC contracting. • Serves as VBC regulatory data and reporting lead by developing and producing as required to engage with provider and facilitate VBC performance. • Supports VBC network throughout the state to include onboarding VBC providers and supporting JOC's. • Clearly and professionally communicates VBC contract terms to VBC providers. • Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes. • Communicates proactively with other departments to ensure effective and efficient business results. • Trains and monitors newly hired Contract Specialist(s). • Participates in other VBC related special projects as directed. • Limited team travel once to twice annually. Job Qualifications REQUIRED EDUCATION: Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field. REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: • 4-6 years' previous experience in contracting with large specialty or multispecialty provider groups. • 1-3 Years Managed Care experience PREFERRED EXPERIENCE: Provider facing experience and knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) highly desirable. Experience generating financial reporting to meet regulatory requirements. Ohio based candidate desired; however, not required.

Responsible for the strategic development and administration of contracts with State and/or Federal governments for Medicaid, Medicare, Marketplace, and other government-sponsored programs to provide health care services to low income, uninsured, and other populations. **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for coordinating, conducting and/or responding to research requests pertaining to government healthcare programs; preparing and submitting regulatory reports for filings; reviewing Plan submissions for quality, accuracy, and timeliness; and ensuring Plan meets contractual and regulatory requirements. + Reviews Provider Agreement, EOC/ Member Handbook, Provider Directory, marketing materials, and other contract reporting deliverables for compliance with contractual and regulatory requirements prior to submission. + Assesses information received from government contracting agencies and regulators and disseminates to impacted Plan staff. + Participates in meetings related to Molina government run programs with State agencies and Molina Corporate departments and disseminates relevant information to staff and management. + Oversees/maintains the department's documentation and archive system, ensuring submitted reports are archived for historical and audit purposes. Ensures system is updated and complete. + Conduct research, interpret, and analyze federal law, rules and regulations as needed to provide guidance, support, and/or direction to internal staff. + Serve as liaison between the department and the organization's business owners/leaders and its staff members. + Assist in maintaining the Operational Review Audit Readiness folders annually and consistently monitor for regulatory changes that could affect operations, particularly contract compliance and audit preparedness. + Support business owners in the preparation of the AHCCCS triannual Operational Review. + Assist in project managing contract implementation, amendments, and state policy changes. + Accountable for the logging, tracking, analysis, follow-up, and reporting of contract deliverables, and for ensuring the system and dashboard remain current. + Responsibilities encompass managing contract deliverables, resubmissions, rejections, inquiries, complaints, internal incidents, disclosures, marketing and member information materials, regulatory requirements, policy updates, annual policy and procedure reviews in collaboration with the Policy Committee, as well as coordinating meetings with the regulatory agency. + Other duties as assigned. **JOB QUALIFICATIONS** **Required Education** High School diploma or equivalent **Required Experience** + 3 years' experience in a managed care environment. + Experience demonstrating strong: communication and presentation skills; analytical/reasoning ability; detail orientation; organizational and interpersonal skills. + Proficient in compiling data, creating reports, and presenting information, using Crystal Reports (or similar reporting tools), SQL query, MS Access, and MS Excel. **Preferred Education** Bachelor's Degree in Business Administration, Healthcare, or related field. 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: $45,390 - $88,511.46 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to financial 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. Responsible for accurate and timely maintenance of Value Based Contracts (VBCs) post execution, including but not limited to, data analysis and reporting that ensures VBCs fulfill APM provider payment and regulatory requirements related to state-mandated value-based programs. Supports Manager with contracting/re-contracting of VBCs, issue escalations and JOCs on exception. Synchronizes data among multiple systems when applicable and ensures adherence to business and system requirements of customers as it pertains to contracting and network management. **Job Duties** This role supports assigned contracts with VBC providers that result in high quality and cost-effective care. Maintains tracking system and publishes reports according to departmental procedures. Contracting/re-contracting of VBCs, issue escalations and Joint Operating Committees on exception. - Assists Manager and/or Director in the negotiation of medical group/IPA and hospital VBC contracting. - Serves as VBC regulatory data and reporting lead by developing and producing as required to engage with provider and facilitate VBC performance. - Supports VBC network throughout the state to include onboarding VBC providers and supporting JOC's. - Clearly and professionally communicates VBC contract terms to VBC providers. - Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes. - Communicates proactively with other departments to ensure effective and efficient business results. - Trains and monitors newly hired Contract Specialist(s). - Participates in other VBC related special projects as directed. - Limited team travel once to twice annually. **Job Qualifications** **REQUIRED EDUCATION:** Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** - 4-6 years' previous experience in contracting with large specialty or multispecialty provider groups. - 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Provider facing experience and knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) highly desirable. Experience generating financial reporting to meet regulatory requirements. Ohio based candidate desired; however, not required. Pay Range: $30.37 - $61.79 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to financial 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. Responsible for accurate and timely maintenance of Value Based Contracts (VBCs) post execution, including but not limited to, data analysis and reporting that ensures VBCs fulfill APM provider payment and regulatory requirements related to state-mandated value-based programs. Supports Manager with contracting/re-contracting of VBCs, issue escalations and JOCs on exception. Synchronizes data among multiple systems when applicable and ensures adherence to business and system requirements of customers as it pertains to contracting and network management. Job Duties This role supports assigned contracts with VBC providers that result in high quality and cost-effective care. Maintains tracking system and publishes reports according to departmental procedures. Contracting/re-contracting of VBCs, issue escalations and Joint Operating Committees on exception. * Assists Manager and/or Director in the negotiation of medical group/IPA and hospital VBC contracting. * Serves as VBC regulatory data and reporting lead by developing and producing as required to engage with provider and facilitate VBC performance. * Supports VBC network throughout the state to include onboarding VBC providers and supporting JOC's. * Clearly and professionally communicates VBC contract terms to VBC providers. * Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes. * Communicates proactively with other departments to ensure effective and efficient business results. * Trains and monitors newly hired Contract Specialist(s). * Participates in other VBC related special projects as directed. * Limited team travel once to twice annually. Job Qualifications REQUIRED EDUCATION: Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field. REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: * 4-6 years' previous experience in contracting with large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience PREFERRED EXPERIENCE: Provider facing experience and knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) highly desirable. Experience generating financial reporting to meet regulatory requirements. Ohio based candidate desired; however, not required. Pay Range: $30.37 - $61.79 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to financial 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. Responsible for accurate and timely maintenance of Value Based Contracts (VBCs) post execution, including but not limited to, data analysis and reporting that ensures VBCs fulfill APM provider payment and regulatory requirements related to state-mandated value-based programs. Supports Manager with contracting/re-contracting of VBCs, issue escalations and JOCs on exception. Synchronizes data among multiple systems when applicable and ensures adherence to business and system requirements of customers as it pertains to contracting and network management. **Job Duties** This role supports assigned contracts with VBC providers that result in high quality and cost-effective care. Maintains tracking system and publishes reports according to departmental procedures. Contracting/re-contracting of VBCs, issue escalations and Joint Operating Committees on exception. - Assists Manager and/or Director in the negotiation of medical group/IPA and hospital VBC contracting. - Serves as VBC regulatory data and reporting lead by developing and producing as required to engage with provider and facilitate VBC performance. - Supports VBC network throughout the state to include onboarding VBC providers and supporting JOC's. - Clearly and professionally communicates VBC contract terms to VBC providers. - Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes. - Communicates proactively with other departments to ensure effective and efficient business results. - Trains and monitors newly hired Contract Specialist(s). - Participates in other VBC related special projects as directed. - Limited team travel once to twice annually. **Job Qualifications** **REQUIRED EDUCATION:** Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** - 4-6 years' previous experience in contracting with large specialty or multispecialty provider groups. - 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Provider facing experience and knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) highly desirable. Experience generating financial reporting to meet regulatory requirements. Ohio based candidate desired; however, not required. Pay Range: $30.37 - $61.79 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to financial 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. Responsible for accurate and timely maintenance of Value Based Contracts (VBCs) post execution, including but not limited to, data analysis and reporting that ensures VBCs fulfill APM provider payment and regulatory requirements related to state-mandated value-based programs. Supports Manager with contracting/re-contracting of VBCs, issue escalations and JOCs on exception. Synchronizes data among multiple systems when applicable and ensures adherence to business and system requirements of customers as it pertains to contracting and network management. **Job Duties** This role supports assigned contracts with VBC providers that result in high quality and cost-effective care. Maintains tracking system and publishes reports according to departmental procedures. Contracting/re-contracting of VBCs, issue escalations and Joint Operating Committees on exception. - Assists Manager and/or Director in the negotiation of medical group/IPA and hospital VBC contracting. - Serves as VBC regulatory data and reporting lead by developing and producing as required to engage with provider and facilitate VBC performance. - Supports VBC network throughout the state to include onboarding VBC providers and supporting JOC's. - Clearly and professionally communicates VBC contract terms to VBC providers. - Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes. - Communicates proactively with other departments to ensure effective and efficient business results. - Trains and monitors newly hired Contract Specialist(s). - Participates in other VBC related special projects as directed. - Limited team travel once to twice annually. **Job Qualifications** **REQUIRED EDUCATION:** Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** - 4-6 years' previous experience in contracting with large specialty or multispecialty provider groups. - 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Provider facing experience and knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) highly desirable. Experience generating financial reporting to meet regulatory requirements. Ohio based candidate desired; however, not required. Pay Range: $30.37 - $61.79 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to financial 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. Responsible for accurate and timely maintenance of Value Based Contracts (VBCs) post execution, including but not limited to, data analysis and reporting that ensures VBCs fulfill APM provider payment and regulatory requirements related to state-mandated value-based programs. Supports Manager with contracting/re-contracting of VBCs, issue escalations and JOCs on exception. Synchronizes data among multiple systems when applicable and ensures adherence to business and system requirements of customers as it pertains to contracting and network management. Job Duties This role supports assigned contracts with VBC providers that result in high quality and cost-effective care. Maintains tracking system and publishes reports according to departmental procedures. Contracting/re-contracting of VBCs, issue escalations and Joint Operating Committees on exception. * Assists Manager and/or Director in the negotiation of medical group/IPA and hospital VBC contracting. * Serves as VBC regulatory data and reporting lead by developing and producing as required to engage with provider and facilitate VBC performance. * Supports VBC network throughout the state to include onboarding VBC providers and supporting JOC's. * Clearly and professionally communicates VBC contract terms to VBC providers. * Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes. * Communicates proactively with other departments to ensure effective and efficient business results. * Trains and monitors newly hired Contract Specialist(s). * Participates in other VBC related special projects as directed. * Limited team travel once to twice annually. Job Qualifications REQUIRED EDUCATION: Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field. REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: * 4-6 years' previous experience in contracting with large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience PREFERRED EXPERIENCE: Provider facing experience and knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) highly desirable. Experience generating financial reporting to meet regulatory requirements. Ohio based candidate desired; however, not required. Pay Range: $30.37 - $61.79 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to financial 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. Responsible for accurate and timely maintenance of Value Based Contracts (VBCs) post execution, including but not limited to, data analysis and reporting that ensures VBCs fulfill APM provider payment and regulatory requirements related to state-mandated value-based programs. Supports Manager with contracting/re-contracting of VBCs, issue escalations and JOCs on exception. Synchronizes data among multiple systems when applicable and ensures adherence to business and system requirements of customers as it pertains to contracting and network management. **Job Duties** This role supports assigned contracts with VBC providers that result in high quality and cost-effective care. Maintains tracking system and publishes reports according to departmental procedures. Contracting/re-contracting of VBCs, issue escalations and Joint Operating Committees on exception. - Assists Manager and/or Director in the negotiation of medical group/IPA and hospital VBC contracting. - Serves as VBC regulatory data and reporting lead by developing and producing as required to engage with provider and facilitate VBC performance. - Supports VBC network throughout the state to include onboarding VBC providers and supporting JOC's. - Clearly and professionally communicates VBC contract terms to VBC providers. - Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes. - Communicates proactively with other departments to ensure effective and efficient business results. - Trains and monitors newly hired Contract Specialist(s). - Participates in other VBC related special projects as directed. - Limited team travel once to twice annually. **Job Qualifications** **REQUIRED EDUCATION:** Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** - 4-6 years' previous experience in contracting with large specialty or multispecialty provider groups. - 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Provider facing experience and knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) highly desirable. Experience generating financial reporting to meet regulatory requirements. Ohio based candidate desired; however, not required. Pay Range: $30.37 - $61.79 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to financial 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. Responsible for accurate and timely maintenance of Value Based Contracts (VBCs) post execution, including but not limited to, data analysis and reporting that ensures VBCs fulfill APM provider payment and regulatory requirements related to state-mandated value-based programs. Supports Manager with contracting/re-contracting of VBCs, issue escalations and JOCs on exception. Synchronizes data among multiple systems when applicable and ensures adherence to business and system requirements of customers as it pertains to contracting and network management. Job Duties This role supports assigned contracts with VBC providers that result in high quality and cost-effective care. Maintains tracking system and publishes reports according to departmental procedures. Contracting/re-contracting of VBCs, issue escalations and Joint Operating Committees on exception. * Assists Manager and/or Director in the negotiation of medical group/IPA and hospital VBC contracting. * Serves as VBC regulatory data and reporting lead by developing and producing as required to engage with provider and facilitate VBC performance. * Supports VBC network throughout the state to include onboarding VBC providers and supporting JOC's. * Clearly and professionally communicates VBC contract terms to VBC providers. * Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes. * Communicates proactively with other departments to ensure effective and efficient business results. * Trains and monitors newly hired Contract Specialist(s). * Participates in other VBC related special projects as directed. * Limited team travel once to twice annually. Job Qualifications REQUIRED EDUCATION: Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field. REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: * 4-6 years' previous experience in contracting with large specialty or multispecialty provider groups. * 1-3 Years Managed Care experience PREFERRED EXPERIENCE: Provider facing experience and knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) highly desirable. Experience generating financial reporting to meet regulatory requirements. Ohio based candidate desired; however, not required. Pay Range: $30.37 - $61.79 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to financial 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. Responsible for accurate and timely maintenance of Value Based Contracts (VBCs) post execution, including but not limited to, data analysis and reporting that ensures VBCs fulfill APM provider payment and regulatory requirements related to state-mandated value-based programs. Supports Manager with contracting/re-contracting of VBCs, issue escalations and JOCs on exception. Synchronizes data among multiple systems when applicable and ensures adherence to business and system requirements of customers as it pertains to contracting and network management. **Job Duties** This role supports assigned contracts with VBC providers that result in high quality and cost-effective care. Maintains tracking system and publishes reports according to departmental procedures. Contracting/re-contracting of VBCs, issue escalations and Joint Operating Committees on exception. - Assists Manager and/or Director in the negotiation of medical group/IPA and hospital VBC contracting. - Serves as VBC regulatory data and reporting lead by developing and producing as required to engage with provider and facilitate VBC performance. - Supports VBC network throughout the state to include onboarding VBC providers and supporting JOC's. - Clearly and professionally communicates VBC contract terms to VBC providers. - Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes. - Communicates proactively with other departments to ensure effective and efficient business results. - Trains and monitors newly hired Contract Specialist(s). - Participates in other VBC related special projects as directed. - Limited team travel once to twice annually. **Job Qualifications** **REQUIRED EDUCATION:** Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** - 4-6 years' previous experience in contracting with large specialty or multispecialty provider groups. - 1-3 Years Managed Care experience **PREFERRED EXPERIENCE** : Provider facing experience and knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) highly desirable. Experience generating financial reporting to meet regulatory requirements. Ohio based candidate desired; however, not required. Pay Range: $30.37 - $61.79 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.