Contracts Manager jobs at Molina Healthcare - 24 jobs

supports and oversees Molina dental providers. 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: $80,168 - $155,508 / ANNUAL * 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.

supports and oversees Molina dental providers. 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: $80,168 - $155,508 / ANNUAL * 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.

supports and oversees Molina dental providers. 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: $80,168 - $155,508 / ANNUAL * 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.

supports and oversees Molina dental providers.** 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: $80,168 - $155,508 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

supports and oversees Molina dental providers. 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: $80,168 - $155,508 / ANNUAL * 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.

supports and oversees Molina dental providers.** 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: $80,168 - $155,508 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Molina's Provider Contracting function provides guidance, signature support services, standards and resources to help Molina Healthcare successfully establish and maintain distinct high performing networks of compassionate and culturally sensitive providers who: * Are aligned with our mission to provide quality health services to financially vulnerable families and individuals covered by government programs; * Help meet or exceed applicable access criteria and adequacy standards for covered services; * Agree to sign standard provider services agreements approved by applicable state/federal agencies and built on Molina's business standards that include sustainable value-based reimbursements; and * Are committed to providing quality healthcare for low income Members in an efficient and caring manner.' Knowledge/Skills/Abilities * Under the leadership of the AVP, Provider Network Management & Operations, oversees development and implementation of provider network and contract strategies, identifying those specialties and geographic locations upon which to concentrate resources for purposes of establishing a sufficient network of Participating Providers to serve the health care needs of Molina membership. * Develops and maintains a standard provider reimbursement strategy consistent with reimbursement tolerance parameters (across multiple specialties/geographies). Obtains input from Corporate, Legal and other stakeholders regarding new reimbursement models and oversees their development. * Develops and maintains a system to track contract negotiation activity on an ongoing basis throughout the year; utilizes and oversees departmental training on the enterprise contract management system (Emptoris). * Directs the preparation of provider contracts and oversees negotiation of contracts in concert with established company templates and guidelines with physicians, hospitals, and other health care providers. * Contributes as a key member of the department's leadership team and participates in committees addressing the department's strategic goals and organization. * Oversees the maintenance of all provider contract information and provider contract templates and ensures that contracts can be configured within the QNXT system. Works with Legal, Corporate and other stakeholders as needed to modify contract templates to ensure compliance with all contractual and/or regulatory requirements. * Monitors and reports network adequacy for Medicare and Medicaid services. * Develops strategies to improve EDI/MASS rates. * Educates and works with assigned state Health Plans on any corporate changes or initiatives as necessary. * Works with assigned national vendors to improve contractual terms and maintain positive relationships. * Provides national contracts support for other Molina departments/functions, including: Provider Services (and activities with provider association(s) and Joint Operating Committee management); Delegation Oversight; Provider Network Administration (provider information management and business analyses of national contracts/benefits to support accurate configuration for claims payment); Provider/Member Inquiry Research and Resolution; and Provider/Member Appeals and Grievances. * Coordinates with Corporate and Business Development teams to ensure that Molina grows faster (profitable growth) than our competitors in target new markets and expansion opportunities. * Provides training and guidance as needed to the Contract Managers and Contract Specialist(s). * Helps develop and utilize standardized contract templates and Pay for Performance strategies. * Utilizes sound reporting and analytical tools to develop and refine strategic work plans.. Job Qualifications Required Education Bachelor's Degree in a related field (Business Administration, etc.) or equivalent experience. Required Experience 7 - 10 years minimum experience in Healthcare Administration, Managed Care, and/or Provider Network Mgmt & Operations with an emphasis on value based provider contracting. Required License, Certification, Association N/A Preferred Education Master's Degree Preferred Experience 3-5 years minimum experience in contracting with hospitals, physician groups, high volume specialists and ancillary providers. Preferred License, Certification, Association N/A 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: $107,028 - $250,446 / ANNUAL * 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's Provider Contracting function provides guidance, signature support services, standards and resources to help Molina Healthcare successfully establish and maintain distinct high performing networks of compassionate and culturally sensitive providers who: - Are aligned with our mission to provide quality health services to financially vulnerable families and individuals covered by government programs; - Help meet or exceed applicable access criteria and adequacy standards for covered services; - Agree to sign standard provider services agreements approved by applicable state/federal agencies and built on Molina's business standards that include sustainable value-based reimbursements; and - Are committed to providing quality healthcare for low income Members in an efficient and caring manner.' **Knowledge/Skills/Abilities** - Under the leadership of the AVP, Provider Network Management & Operations, oversees development and implementation of provider network and contract strategies, identifying those specialties and geographic locations upon which to concentrate resources for purposes of establishing a sufficient network of Participating Providers to serve the health care needs of Molina membership. - Develops and maintains a standard provider reimbursement strategy consistent with reimbursement tolerance parameters (across multiple specialties/geographies). Obtains input from Corporate, Legal and other stakeholders regarding new reimbursement models and oversees their development. - Develops and maintains a system to track contract negotiation activity on an ongoing basis throughout the year; utilizes and oversees departmental training on the enterprise contract management system (Emptoris). - Directs the preparation of provider contracts and oversees negotiation of contracts in concert with established company templates and guidelines with physicians, hospitals, and other health care providers. - Contributes as a key member of the department's leadership team and participates in committees addressing the department's strategic goals and organization. - Oversees the maintenance of all provider contract information and provider contract templates and ensures that contracts can be configured within the QNXT system. Works with Legal, Corporate and other stakeholders as needed to modify contract templates to ensure compliance with all contractual and/or regulatory requirements. - Monitors and reports network adequacy for Medicare and Medicaid services. - Develops strategies to improve EDI/MASS rates. - Educates and works with assigned state Health Plans on any corporate changes or initiatives as necessary. - Works with assigned national vendors to improve contractual terms and maintain positive relationships. - Provides national contracts support for other Molina departments/functions, including: Provider Services (and activities with provider association(s) and Joint Operating Committee management); Delegation Oversight; Provider Network Administration (provider information management and business analyses of national contracts/benefits to support accurate configuration for claims payment); Provider/Member Inquiry Research and Resolution; and Provider/Member Appeals and Grievances. - Coordinates with Corporate and Business Development teams to ensure that Molina grows faster (profitable growth) than our competitors in target new markets and expansion opportunities. - Provides training and guidance as needed to the Contract Managers and Contract Specialist(s). - Helps develop and utilize standardized contract templates and Pay for Performance strategies. - Utilizes sound reporting and analytical tools to develop and refine strategic work plans.. **Job Qualifications** **Required Education** Bachelor's Degree in a related field (Business Administration, etc.) or equivalent experience. **Required Experience** 7 - 10 years minimum experience in Healthcare Administration, Managed Care, and/or Provider Network Mgmt & Operations with an emphasis on value based provider contracting. **Required License, Certification, Association** N/A **Preferred Education** Master's Degree **Preferred Experience** 3-5 years minimum experience in contracting with hospitals, physician groups, high volume specialists and ancillary providers. **Preferred License, Certification, Association** N/A 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: $107,028 - $250,446 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

supports and oversees Molina dental providers. 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: $80,168 - $155,508 / ANNUAL * 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's Provider Contracting function provides guidance, signature support services, standards and resources to help Molina Healthcare successfully establish and maintain distinct high performing networks of compassionate and culturally sensitive providers who: * Are aligned with our mission to provide quality health services to financially vulnerable families and individuals covered by government programs; * Help meet or exceed applicable access criteria and adequacy standards for covered services; * Agree to sign standard provider services agreements approved by applicable state/federal agencies and built on Molina's business standards that include sustainable value-based reimbursements; and * Are committed to providing quality healthcare for low income Members in an efficient and caring manner.' Knowledge/Skills/Abilities * Under the leadership of the AVP, Provider Network Management & Operations, oversees development and implementation of provider network and contract strategies, identifying those specialties and geographic locations upon which to concentrate resources for purposes of establishing a sufficient network of Participating Providers to serve the health care needs of Molina membership. * Develops and maintains a standard provider reimbursement strategy consistent with reimbursement tolerance parameters (across multiple specialties/geographies). Obtains input from Corporate, Legal and other stakeholders regarding new reimbursement models and oversees their development. * Develops and maintains a system to track contract negotiation activity on an ongoing basis throughout the year; utilizes and oversees departmental training on the enterprise contract management system (Emptoris). * Directs the preparation of provider contracts and oversees negotiation of contracts in concert with established company templates and guidelines with physicians, hospitals, and other health care providers. * Contributes as a key member of the department's leadership team and participates in committees addressing the department's strategic goals and organization. * Oversees the maintenance of all provider contract information and provider contract templates and ensures that contracts can be configured within the QNXT system. Works with Legal, Corporate and other stakeholders as needed to modify contract templates to ensure compliance with all contractual and/or regulatory requirements. * Monitors and reports network adequacy for Medicare and Medicaid services. * Develops strategies to improve EDI/MASS rates. * Educates and works with assigned state Health Plans on any corporate changes or initiatives as necessary. * Works with assigned national vendors to improve contractual terms and maintain positive relationships. * Provides national contracts support for other Molina departments/functions, including: Provider Services (and activities with provider association(s) and Joint Operating Committee management); Delegation Oversight; Provider Network Administration (provider information management and business analyses of national contracts/benefits to support accurate configuration for claims payment); Provider/Member Inquiry Research and Resolution; and Provider/Member Appeals and Grievances. * Coordinates with Corporate and Business Development teams to ensure that Molina grows faster (profitable growth) than our competitors in target new markets and expansion opportunities. * Provides training and guidance as needed to the Contract Managers and Contract Specialist(s). * Helps develop and utilize standardized contract templates and Pay for Performance strategies. * Utilizes sound reporting and analytical tools to develop and refine strategic work plans.. Job Qualifications Required Education Bachelor's Degree in a related field (Business Administration, etc.) or equivalent experience. Required Experience 7 - 10 years minimum experience in Healthcare Administration, Managed Care, and/or Provider Network Mgmt & Operations with an emphasis on value based provider contracting. Required License, Certification, Association N/A Preferred Education Master's Degree Preferred Experience 3-5 years minimum experience in contracting with hospitals, physician groups, high volume specialists and ancillary providers. Preferred License, Certification, Association N/A 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: $107,028 - $250,446 / ANNUAL * 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's Provider Contracting function provides guidance, signature support services, standards and resources to help Molina Healthcare successfully establish and maintain distinct high performing networks of compassionate and culturally sensitive providers who: - Are aligned with our mission to provide quality health services to financially vulnerable families and individuals covered by government programs; - Help meet or exceed applicable access criteria and adequacy standards for covered services; - Agree to sign standard provider services agreements approved by applicable state/federal agencies and built on Molina's business standards that include sustainable value-based reimbursements; and - Are committed to providing quality healthcare for low income Members in an efficient and caring manner.' **Knowledge/Skills/Abilities** - Under the leadership of the AVP, Provider Network Management & Operations, oversees development and implementation of provider network and contract strategies, identifying those specialties and geographic locations upon which to concentrate resources for purposes of establishing a sufficient network of Participating Providers to serve the health care needs of Molina membership. - Develops and maintains a standard provider reimbursement strategy consistent with reimbursement tolerance parameters (across multiple specialties/geographies). Obtains input from Corporate, Legal and other stakeholders regarding new reimbursement models and oversees their development. - Develops and maintains a system to track contract negotiation activity on an ongoing basis throughout the year; utilizes and oversees departmental training on the enterprise contract management system (Emptoris). - Directs the preparation of provider contracts and oversees negotiation of contracts in concert with established company templates and guidelines with physicians, hospitals, and other health care providers. - Contributes as a key member of the department's leadership team and participates in committees addressing the department's strategic goals and organization. - Oversees the maintenance of all provider contract information and provider contract templates and ensures that contracts can be configured within the QNXT system. Works with Legal, Corporate and other stakeholders as needed to modify contract templates to ensure compliance with all contractual and/or regulatory requirements. - Monitors and reports network adequacy for Medicare and Medicaid services. - Develops strategies to improve EDI/MASS rates. - Educates and works with assigned state Health Plans on any corporate changes or initiatives as necessary. - Works with assigned national vendors to improve contractual terms and maintain positive relationships. - Provides national contracts support for other Molina departments/functions, including: Provider Services (and activities with provider association(s) and Joint Operating Committee management); Delegation Oversight; Provider Network Administration (provider information management and business analyses of national contracts/benefits to support accurate configuration for claims payment); Provider/Member Inquiry Research and Resolution; and Provider/Member Appeals and Grievances. - Coordinates with Corporate and Business Development teams to ensure that Molina grows faster (profitable growth) than our competitors in target new markets and expansion opportunities. - Provides training and guidance as needed to the Contract Managers and Contract Specialist(s). - Helps develop and utilize standardized contract templates and Pay for Performance strategies. - Utilizes sound reporting and analytical tools to develop and refine strategic work plans.. **Job Qualifications** **Required Education** Bachelor's Degree in a related field (Business Administration, etc.) or equivalent experience. **Required Experience** 7 - 10 years minimum experience in Healthcare Administration, Managed Care, and/or Provider Network Mgmt & Operations with an emphasis on value based provider contracting. **Required License, Certification, Association** N/A **Preferred Education** Master's Degree **Preferred Experience** 3-5 years minimum experience in contracting with hospitals, physician groups, high volume specialists and ancillary providers. **Preferred License, Certification, Association** N/A 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: $107,028 - $250,446 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Molina's Provider Contracting function provides guidance, signature support services, standards and resources to help Molina Healthcare successfully establish and maintain distinct high performing networks of compassionate and culturally sensitive providers who: * Are aligned with our mission to provide quality health services to financially vulnerable families and individuals covered by government programs; * Help meet or exceed applicable access criteria and adequacy standards for covered services; * Agree to sign standard provider services agreements approved by applicable state/federal agencies and built on Molina's business standards that include sustainable value-based reimbursements; and * Are committed to providing quality healthcare for low income Members in an efficient and caring manner.' Knowledge/Skills/Abilities * Under the leadership of the AVP, Provider Network Management & Operations, oversees development and implementation of provider network and contract strategies, identifying those specialties and geographic locations upon which to concentrate resources for purposes of establishing a sufficient network of Participating Providers to serve the health care needs of Molina membership. * Develops and maintains a standard provider reimbursement strategy consistent with reimbursement tolerance parameters (across multiple specialties/geographies). Obtains input from Corporate, Legal and other stakeholders regarding new reimbursement models and oversees their development. * Develops and maintains a system to track contract negotiation activity on an ongoing basis throughout the year; utilizes and oversees departmental training on the enterprise contract management system (Emptoris). * Directs the preparation of provider contracts and oversees negotiation of contracts in concert with established company templates and guidelines with physicians, hospitals, and other health care providers. * Contributes as a key member of the department's leadership team and participates in committees addressing the department's strategic goals and organization. * Oversees the maintenance of all provider contract information and provider contract templates and ensures that contracts can be configured within the QNXT system. Works with Legal, Corporate and other stakeholders as needed to modify contract templates to ensure compliance with all contractual and/or regulatory requirements. * Monitors and reports network adequacy for Medicare and Medicaid services. * Develops strategies to improve EDI/MASS rates. * Educates and works with assigned state Health Plans on any corporate changes or initiatives as necessary. * Works with assigned national vendors to improve contractual terms and maintain positive relationships. * Provides national contracts support for other Molina departments/functions, including: Provider Services (and activities with provider association(s) and Joint Operating Committee management); Delegation Oversight; Provider Network Administration (provider information management and business analyses of national contracts/benefits to support accurate configuration for claims payment); Provider/Member Inquiry Research and Resolution; and Provider/Member Appeals and Grievances. * Coordinates with Corporate and Business Development teams to ensure that Molina grows faster (profitable growth) than our competitors in target new markets and expansion opportunities. * Provides training and guidance as needed to the Contract Managers and Contract Specialist(s). * Helps develop and utilize standardized contract templates and Pay for Performance strategies. * Utilizes sound reporting and analytical tools to develop and refine strategic work plans.. Job Qualifications Required Education Bachelor's Degree in a related field (Business Administration, etc.) or equivalent experience. Required Experience 7 - 10 years minimum experience in Healthcare Administration, Managed Care, and/or Provider Network Mgmt & Operations with an emphasis on value based provider contracting. Required License, Certification, Association N/A Preferred Education Master's Degree Preferred Experience 3-5 years minimum experience in contracting with hospitals, physician groups, high volume specialists and ancillary providers. Preferred License, Certification, Association N/A 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: $107,028 - $250,446 / ANNUAL * 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's Provider Contracting function provides guidance, signature support services, standards and resources to help Molina Healthcare successfully establish and maintain distinct high performing networks of compassionate and culturally sensitive providers who: - Are aligned with our mission to provide quality health services to financially vulnerable families and individuals covered by government programs; - Help meet or exceed applicable access criteria and adequacy standards for covered services; - Agree to sign standard provider services agreements approved by applicable state/federal agencies and built on Molina's business standards that include sustainable value-based reimbursements; and - Are committed to providing quality healthcare for low income Members in an efficient and caring manner.' **Knowledge/Skills/Abilities** - Under the leadership of the AVP, Provider Network Management & Operations, oversees development and implementation of provider network and contract strategies, identifying those specialties and geographic locations upon which to concentrate resources for purposes of establishing a sufficient network of Participating Providers to serve the health care needs of Molina membership. - Develops and maintains a standard provider reimbursement strategy consistent with reimbursement tolerance parameters (across multiple specialties/geographies). Obtains input from Corporate, Legal and other stakeholders regarding new reimbursement models and oversees their development. - Develops and maintains a system to track contract negotiation activity on an ongoing basis throughout the year; utilizes and oversees departmental training on the enterprise contract management system (Emptoris). - Directs the preparation of provider contracts and oversees negotiation of contracts in concert with established company templates and guidelines with physicians, hospitals, and other health care providers. - Contributes as a key member of the department's leadership team and participates in committees addressing the department's strategic goals and organization. - Oversees the maintenance of all provider contract information and provider contract templates and ensures that contracts can be configured within the QNXT system. Works with Legal, Corporate and other stakeholders as needed to modify contract templates to ensure compliance with all contractual and/or regulatory requirements. - Monitors and reports network adequacy for Medicare and Medicaid services. - Develops strategies to improve EDI/MASS rates. - Educates and works with assigned state Health Plans on any corporate changes or initiatives as necessary. - Works with assigned national vendors to improve contractual terms and maintain positive relationships. - Provides national contracts support for other Molina departments/functions, including: Provider Services (and activities with provider association(s) and Joint Operating Committee management); Delegation Oversight; Provider Network Administration (provider information management and business analyses of national contracts/benefits to support accurate configuration for claims payment); Provider/Member Inquiry Research and Resolution; and Provider/Member Appeals and Grievances. - Coordinates with Corporate and Business Development teams to ensure that Molina grows faster (profitable growth) than our competitors in target new markets and expansion opportunities. - Provides training and guidance as needed to the Contract Managers and Contract Specialist(s). - Helps develop and utilize standardized contract templates and Pay for Performance strategies. - Utilizes sound reporting and analytical tools to develop and refine strategic work plans.. **Job Qualifications** **Required Education** Bachelor's Degree in a related field (Business Administration, etc.) or equivalent experience. **Required Experience** 7 - 10 years minimum experience in Healthcare Administration, Managed Care, and/or Provider Network Mgmt & Operations with an emphasis on value based provider contracting. **Required License, Certification, Association** N/A **Preferred Education** Master's Degree **Preferred Experience** 3-5 years minimum experience in contracting with hospitals, physician groups, high volume specialists and ancillary providers. **Preferred License, Certification, Association** N/A 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: $107,028 - $250,446 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Molina's Provider Contracting function provides guidance, signature support services, standards and resources to help Molina Healthcare successfully establish and maintain distinct high performing networks of compassionate and culturally sensitive providers who: * Are aligned with our mission to provide quality health services to financially vulnerable families and individuals covered by government programs; * Help meet or exceed applicable access criteria and adequacy standards for covered services; * Agree to sign standard provider services agreements approved by applicable state/federal agencies and built on Molina's business standards that include sustainable value-based reimbursements; and * Are committed to providing quality healthcare for low income Members in an efficient and caring manner.' Knowledge/Skills/Abilities * Under the leadership of the AVP, Provider Network Management & Operations, oversees development and implementation of provider network and contract strategies, identifying those specialties and geographic locations upon which to concentrate resources for purposes of establishing a sufficient network of Participating Providers to serve the health care needs of Molina membership. * Develops and maintains a standard provider reimbursement strategy consistent with reimbursement tolerance parameters (across multiple specialties/geographies). Obtains input from Corporate, Legal and other stakeholders regarding new reimbursement models and oversees their development. * Develops and maintains a system to track contract negotiation activity on an ongoing basis throughout the year; utilizes and oversees departmental training on the enterprise contract management system (Emptoris). * Directs the preparation of provider contracts and oversees negotiation of contracts in concert with established company templates and guidelines with physicians, hospitals, and other health care providers. * Contributes as a key member of the department's leadership team and participates in committees addressing the department's strategic goals and organization. * Oversees the maintenance of all provider contract information and provider contract templates and ensures that contracts can be configured within the QNXT system. Works with Legal, Corporate and other stakeholders as needed to modify contract templates to ensure compliance with all contractual and/or regulatory requirements. * Monitors and reports network adequacy for Medicare and Medicaid services. * Develops strategies to improve EDI/MASS rates. * Educates and works with assigned state Health Plans on any corporate changes or initiatives as necessary. * Works with assigned national vendors to improve contractual terms and maintain positive relationships. * Provides national contracts support for other Molina departments/functions, including: Provider Services (and activities with provider association(s) and Joint Operating Committee management); Delegation Oversight; Provider Network Administration (provider information management and business analyses of national contracts/benefits to support accurate configuration for claims payment); Provider/Member Inquiry Research and Resolution; and Provider/Member Appeals and Grievances. * Coordinates with Corporate and Business Development teams to ensure that Molina grows faster (profitable growth) than our competitors in target new markets and expansion opportunities. * Provides training and guidance as needed to the Contract Managers and Contract Specialist(s). * Helps develop and utilize standardized contract templates and Pay for Performance strategies. * Utilizes sound reporting and analytical tools to develop and refine strategic work plans.. Job Qualifications Required Education Bachelor's Degree in a related field (Business Administration, etc.) or equivalent experience. Required Experience 7 - 10 years minimum experience in Healthcare Administration, Managed Care, and/or Provider Network Mgmt & Operations with an emphasis on value based provider contracting. Required License, Certification, Association N/A Preferred Education Master's Degree Preferred Experience 3-5 years minimum experience in contracting with hospitals, physician groups, high volume specialists and ancillary providers. Preferred License, Certification, Association N/A 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: $107,028 - $250,446 / ANNUAL * 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's Provider Contracting function provides guidance, signature support services, standards and resources to help Molina Healthcare successfully establish and maintain distinct high performing networks of compassionate and culturally sensitive providers who: - Are aligned with our mission to provide quality health services to financially vulnerable families and individuals covered by government programs; - Help meet or exceed applicable access criteria and adequacy standards for covered services; - Agree to sign standard provider services agreements approved by applicable state/federal agencies and built on Molina's business standards that include sustainable value-based reimbursements; and - Are committed to providing quality healthcare for low income Members in an efficient and caring manner.' **Knowledge/Skills/Abilities** - Under the leadership of the AVP, Provider Network Management & Operations, oversees development and implementation of provider network and contract strategies, identifying those specialties and geographic locations upon which to concentrate resources for purposes of establishing a sufficient network of Participating Providers to serve the health care needs of Molina membership. - Develops and maintains a standard provider reimbursement strategy consistent with reimbursement tolerance parameters (across multiple specialties/geographies). Obtains input from Corporate, Legal and other stakeholders regarding new reimbursement models and oversees their development. - Develops and maintains a system to track contract negotiation activity on an ongoing basis throughout the year; utilizes and oversees departmental training on the enterprise contract management system (Emptoris). - Directs the preparation of provider contracts and oversees negotiation of contracts in concert with established company templates and guidelines with physicians, hospitals, and other health care providers. - Contributes as a key member of the department's leadership team and participates in committees addressing the department's strategic goals and organization. - Oversees the maintenance of all provider contract information and provider contract templates and ensures that contracts can be configured within the QNXT system. Works with Legal, Corporate and other stakeholders as needed to modify contract templates to ensure compliance with all contractual and/or regulatory requirements. - Monitors and reports network adequacy for Medicare and Medicaid services. - Develops strategies to improve EDI/MASS rates. - Educates and works with assigned state Health Plans on any corporate changes or initiatives as necessary. - Works with assigned national vendors to improve contractual terms and maintain positive relationships. - Provides national contracts support for other Molina departments/functions, including: Provider Services (and activities with provider association(s) and Joint Operating Committee management); Delegation Oversight; Provider Network Administration (provider information management and business analyses of national contracts/benefits to support accurate configuration for claims payment); Provider/Member Inquiry Research and Resolution; and Provider/Member Appeals and Grievances. - Coordinates with Corporate and Business Development teams to ensure that Molina grows faster (profitable growth) than our competitors in target new markets and expansion opportunities. - Provides training and guidance as needed to the Contract Managers and Contract Specialist(s). - Helps develop and utilize standardized contract templates and Pay for Performance strategies. - Utilizes sound reporting and analytical tools to develop and refine strategic work plans.. **Job Qualifications** **Required Education** Bachelor's Degree in a related field (Business Administration, etc.) or equivalent experience. **Required Experience** 7 - 10 years minimum experience in Healthcare Administration, Managed Care, and/or Provider Network Mgmt & Operations with an emphasis on value based provider contracting. **Required License, Certification, Association** N/A **Preferred Education** Master's Degree **Preferred Experience** 3-5 years minimum experience in contracting with hospitals, physician groups, high volume specialists and ancillary providers. **Preferred License, Certification, Association** N/A 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: $107,028 - $250,446 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Molina's Provider Contracting function provides guidance, signature support services, standards and resources to help Molina Healthcare successfully establish and maintain distinct high performing networks of compassionate and culturally sensitive providers who: * Are aligned with our mission to provide quality health services to financially vulnerable families and individuals covered by government programs; * Help meet or exceed applicable access criteria and adequacy standards for covered services; * Agree to sign standard provider services agreements approved by applicable state/federal agencies and built on Molina's business standards that include sustainable value-based reimbursements; and * Are committed to providing quality healthcare for low income Members in an efficient and caring manner.' Knowledge/Skills/Abilities * Under the leadership of the AVP, Provider Network Management & Operations, oversees development and implementation of provider network and contract strategies, identifying those specialties and geographic locations upon which to concentrate resources for purposes of establishing a sufficient network of Participating Providers to serve the health care needs of Molina membership. * Develops and maintains a standard provider reimbursement strategy consistent with reimbursement tolerance parameters (across multiple specialties/geographies). Obtains input from Corporate, Legal and other stakeholders regarding new reimbursement models and oversees their development. * Develops and maintains a system to track contract negotiation activity on an ongoing basis throughout the year; utilizes and oversees departmental training on the enterprise contract management system (Emptoris). * Directs the preparation of provider contracts and oversees negotiation of contracts in concert with established company templates and guidelines with physicians, hospitals, and other health care providers. * Contributes as a key member of the department's leadership team and participates in committees addressing the department's strategic goals and organization. * Oversees the maintenance of all provider contract information and provider contract templates and ensures that contracts can be configured within the QNXT system. Works with Legal, Corporate and other stakeholders as needed to modify contract templates to ensure compliance with all contractual and/or regulatory requirements. * Monitors and reports network adequacy for Medicare and Medicaid services. * Develops strategies to improve EDI/MASS rates. * Educates and works with assigned state Health Plans on any corporate changes or initiatives as necessary. * Works with assigned national vendors to improve contractual terms and maintain positive relationships. * Provides national contracts support for other Molina departments/functions, including: Provider Services (and activities with provider association(s) and Joint Operating Committee management); Delegation Oversight; Provider Network Administration (provider information management and business analyses of national contracts/benefits to support accurate configuration for claims payment); Provider/Member Inquiry Research and Resolution; and Provider/Member Appeals and Grievances. * Coordinates with Corporate and Business Development teams to ensure that Molina grows faster (profitable growth) than our competitors in target new markets and expansion opportunities. * Provides training and guidance as needed to the Contract Managers and Contract Specialist(s). * Helps develop and utilize standardized contract templates and Pay for Performance strategies. * Utilizes sound reporting and analytical tools to develop and refine strategic work plans.. Job Qualifications Required Education Bachelor's Degree in a related field (Business Administration, etc.) or equivalent experience. Required Experience 7 - 10 years minimum experience in Healthcare Administration, Managed Care, and/or Provider Network Mgmt & Operations with an emphasis on value based provider contracting. Required License, Certification, Association N/A Preferred Education Master's Degree Preferred Experience 3-5 years minimum experience in contracting with hospitals, physician groups, high volume specialists and ancillary providers. Preferred License, Certification, Association N/A 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: $107,028 - $250,446 / ANNUAL * 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's Provider Contracting function provides guidance, signature support services, standards and resources to help Molina Healthcare successfully establish and maintain distinct high performing networks of compassionate and culturally sensitive providers who: - Are aligned with our mission to provide quality health services to financially vulnerable families and individuals covered by government programs; - Help meet or exceed applicable access criteria and adequacy standards for covered services; - Agree to sign standard provider services agreements approved by applicable state/federal agencies and built on Molina's business standards that include sustainable value-based reimbursements; and - Are committed to providing quality healthcare for low income Members in an efficient and caring manner.' **Knowledge/Skills/Abilities** - Under the leadership of the AVP, Provider Network Management & Operations, oversees development and implementation of provider network and contract strategies, identifying those specialties and geographic locations upon which to concentrate resources for purposes of establishing a sufficient network of Participating Providers to serve the health care needs of Molina membership. - Develops and maintains a standard provider reimbursement strategy consistent with reimbursement tolerance parameters (across multiple specialties/geographies). Obtains input from Corporate, Legal and other stakeholders regarding new reimbursement models and oversees their development. - Develops and maintains a system to track contract negotiation activity on an ongoing basis throughout the year; utilizes and oversees departmental training on the enterprise contract management system (Emptoris). - Directs the preparation of provider contracts and oversees negotiation of contracts in concert with established company templates and guidelines with physicians, hospitals, and other health care providers. - Contributes as a key member of the department's leadership team and participates in committees addressing the department's strategic goals and organization. - Oversees the maintenance of all provider contract information and provider contract templates and ensures that contracts can be configured within the QNXT system. Works with Legal, Corporate and other stakeholders as needed to modify contract templates to ensure compliance with all contractual and/or regulatory requirements. - Monitors and reports network adequacy for Medicare and Medicaid services. - Develops strategies to improve EDI/MASS rates. - Educates and works with assigned state Health Plans on any corporate changes or initiatives as necessary. - Works with assigned national vendors to improve contractual terms and maintain positive relationships. - Provides national contracts support for other Molina departments/functions, including: Provider Services (and activities with provider association(s) and Joint Operating Committee management); Delegation Oversight; Provider Network Administration (provider information management and business analyses of national contracts/benefits to support accurate configuration for claims payment); Provider/Member Inquiry Research and Resolution; and Provider/Member Appeals and Grievances. - Coordinates with Corporate and Business Development teams to ensure that Molina grows faster (profitable growth) than our competitors in target new markets and expansion opportunities. - Provides training and guidance as needed to the Contract Managers and Contract Specialist(s). - Helps develop and utilize standardized contract templates and Pay for Performance strategies. - Utilizes sound reporting and analytical tools to develop and refine strategic work plans.. **Job Qualifications** **Required Education** Bachelor's Degree in a related field (Business Administration, etc.) or equivalent experience. **Required Experience** 7 - 10 years minimum experience in Healthcare Administration, Managed Care, and/or Provider Network Mgmt & Operations with an emphasis on value based provider contracting. **Required License, Certification, Association** N/A **Preferred Education** Master's Degree **Preferred Experience** 3-5 years minimum experience in contracting with hospitals, physician groups, high volume specialists and ancillary providers. **Preferred License, Certification, Association** N/A 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: $107,028 - $250,446 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Molina's Provider Contracting function provides guidance, signature support services, standards and resources to help Molina Healthcare successfully establish and maintain distinct high performing networks of compassionate and culturally sensitive providers who: * Are aligned with our mission to provide quality health services to financially vulnerable families and individuals covered by government programs; * Help meet or exceed applicable access criteria and adequacy standards for covered services; * Agree to sign standard provider services agreements approved by applicable state/federal agencies and built on Molina's business standards that include sustainable value-based reimbursements; and * Are committed to providing quality healthcare for low income Members in an efficient and caring manner.' Knowledge/Skills/Abilities * Under the leadership of the AVP, Provider Network Management & Operations, oversees development and implementation of provider network and contract strategies, identifying those specialties and geographic locations upon which to concentrate resources for purposes of establishing a sufficient network of Participating Providers to serve the health care needs of Molina membership. * Develops and maintains a standard provider reimbursement strategy consistent with reimbursement tolerance parameters (across multiple specialties/geographies). Obtains input from Corporate, Legal and other stakeholders regarding new reimbursement models and oversees their development. * Develops and maintains a system to track contract negotiation activity on an ongoing basis throughout the year; utilizes and oversees departmental training on the enterprise contract management system (Emptoris). * Directs the preparation of provider contracts and oversees negotiation of contracts in concert with established company templates and guidelines with physicians, hospitals, and other health care providers. * Contributes as a key member of the department's leadership team and participates in committees addressing the department's strategic goals and organization. * Oversees the maintenance of all provider contract information and provider contract templates and ensures that contracts can be configured within the QNXT system. Works with Legal, Corporate and other stakeholders as needed to modify contract templates to ensure compliance with all contractual and/or regulatory requirements. * Monitors and reports network adequacy for Medicare and Medicaid services. * Develops strategies to improve EDI/MASS rates. * Educates and works with assigned state Health Plans on any corporate changes or initiatives as necessary. * Works with assigned national vendors to improve contractual terms and maintain positive relationships. * Provides national contracts support for other Molina departments/functions, including: Provider Services (and activities with provider association(s) and Joint Operating Committee management); Delegation Oversight; Provider Network Administration (provider information management and business analyses of national contracts/benefits to support accurate configuration for claims payment); Provider/Member Inquiry Research and Resolution; and Provider/Member Appeals and Grievances. * Coordinates with Corporate and Business Development teams to ensure that Molina grows faster (profitable growth) than our competitors in target new markets and expansion opportunities. * Provides training and guidance as needed to the Contract Managers and Contract Specialist(s). * Helps develop and utilize standardized contract templates and Pay for Performance strategies. * Utilizes sound reporting and analytical tools to develop and refine strategic work plans.. Job Qualifications Required Education Bachelor's Degree in a related field (Business Administration, etc.) or equivalent experience. Required Experience 7 - 10 years minimum experience in Healthcare Administration, Managed Care, and/or Provider Network Mgmt & Operations with an emphasis on value based provider contracting. Required License, Certification, Association N/A Preferred Education Master's Degree Preferred Experience 3-5 years minimum experience in contracting with hospitals, physician groups, high volume specialists and ancillary providers. Preferred License, Certification, Association N/A 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: $107,028 - $250,446 / ANNUAL * 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's Provider Contracting function provides guidance, signature support services, standards and resources to help Molina Healthcare successfully establish and maintain distinct high performing networks of compassionate and culturally sensitive providers who: - Are aligned with our mission to provide quality health services to financially vulnerable families and individuals covered by government programs; - Help meet or exceed applicable access criteria and adequacy standards for covered services; - Agree to sign standard provider services agreements approved by applicable state/federal agencies and built on Molina's business standards that include sustainable value-based reimbursements; and - Are committed to providing quality healthcare for low income Members in an efficient and caring manner.' **Knowledge/Skills/Abilities** - Under the leadership of the AVP, Provider Network Management & Operations, oversees development and implementation of provider network and contract strategies, identifying those specialties and geographic locations upon which to concentrate resources for purposes of establishing a sufficient network of Participating Providers to serve the health care needs of Molina membership. - Develops and maintains a standard provider reimbursement strategy consistent with reimbursement tolerance parameters (across multiple specialties/geographies). Obtains input from Corporate, Legal and other stakeholders regarding new reimbursement models and oversees their development. - Develops and maintains a system to track contract negotiation activity on an ongoing basis throughout the year; utilizes and oversees departmental training on the enterprise contract management system (Emptoris). - Directs the preparation of provider contracts and oversees negotiation of contracts in concert with established company templates and guidelines with physicians, hospitals, and other health care providers. - Contributes as a key member of the department's leadership team and participates in committees addressing the department's strategic goals and organization. - Oversees the maintenance of all provider contract information and provider contract templates and ensures that contracts can be configured within the QNXT system. Works with Legal, Corporate and other stakeholders as needed to modify contract templates to ensure compliance with all contractual and/or regulatory requirements. - Monitors and reports network adequacy for Medicare and Medicaid services. - Develops strategies to improve EDI/MASS rates. - Educates and works with assigned state Health Plans on any corporate changes or initiatives as necessary. - Works with assigned national vendors to improve contractual terms and maintain positive relationships. - Provides national contracts support for other Molina departments/functions, including: Provider Services (and activities with provider association(s) and Joint Operating Committee management); Delegation Oversight; Provider Network Administration (provider information management and business analyses of national contracts/benefits to support accurate configuration for claims payment); Provider/Member Inquiry Research and Resolution; and Provider/Member Appeals and Grievances. - Coordinates with Corporate and Business Development teams to ensure that Molina grows faster (profitable growth) than our competitors in target new markets and expansion opportunities. - Provides training and guidance as needed to the Contract Managers and Contract Specialist(s). - Helps develop and utilize standardized contract templates and Pay for Performance strategies. - Utilizes sound reporting and analytical tools to develop and refine strategic work plans.. **Job Qualifications** **Required Education** Bachelor's Degree in a related field (Business Administration, etc.) or equivalent experience. **Required Experience** 7 - 10 years minimum experience in Healthcare Administration, Managed Care, and/or Provider Network Mgmt & Operations with an emphasis on value based provider contracting. **Required License, Certification, Association** N/A **Preferred Education** Master's Degree **Preferred Experience** 3-5 years minimum experience in contracting with hospitals, physician groups, high volume specialists and ancillary providers. **Preferred License, Certification, Association** N/A 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: $107,028 - $250,446 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.