Contracts Specialist jobs at Molina Healthcare

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.

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 adequacy, financial performance 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. Negotiates agreements with Complex providers who are strategic to the success of the Plan, including but not limited to, Hospitals, Independent Physician Association, and complex Behavioral Health arrangements. **Job Duties** This role negotiates contracts with the Complex Provider Community that result in high quality, cost effective and marketable providers. Contract/Re-contracting with large scale entities involving custom reimbursement. Executes standardized Alternative Payment Method contracts. Issue escalations, network adequacy, Joint Operating Committees, and delegation oversight. Tighter knit proximity ongoing after contract. - In conjunction with Director/Manager, Provider Contracts, negotiates Complex Provider contracts including but not limited to high priority physician group and facility contracts using Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines. Emphasis on number or percentage of Membership in Value Based Relationship Contracts. - Develops and maintains provider contracts in 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. - Advises Network Provider Contract Specialists on negotiation of individual provider and routine ancillary contracts. - Maintains contractual relationships with significant/highly visible providers. - 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, legal and VP level engagement as required. - Educates internal customers on provider contracts. - Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers. - Participates with the management team and other committees addressing the strategic goals of the department and organization. - Participates in other contracting related special projects as directed. - Rarely travels within the state. **Job Qualifications** **REQUIRED EDUCATION** : Bachelor's Degree in a healthcare related field or an equivalent combination of education and experience. **REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : - 5-7 years contract-related experience in the health care field including, but not limited to, provider's office, managed care organization, or other health care environment. - 3+ years experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e. physician, group and hospital contracting, etc. - Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to: Value Based Payment, fee-for service, capitation and various forms of risk, ASO, etc. **PREFERRED EDUCATION** : Master's Degree in a related field or an equivalent combination of education and experience **PREFERRED EXPERIENCE** : 3+ years in Provider Network contracting 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. \#PJCorp \#LI-AC1 Pay Range: $66,456 - $129,590 / 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.

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 adequacy, financial performance 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. Negotiates agreements with Complex providers who are strategic to the success of the Plan, including but not limited to, Hospitals, Independent Physician Association, and complex Behavioral Health arrangements. Job Duties This role negotiates contracts with the Complex Provider Community that result in high quality, cost effective and marketable providers. Contract/Re-contracting with large scale entities involving custom reimbursement. Executes standardized Alternative Payment Method contracts. Issue escalations, network adequacy, Joint Operating Committees, and delegation oversight. Tighter knit proximity ongoing after contract. • In conjunction with Director/Manager, Provider Contracts, negotiates Complex Provider contracts including but not limited to high priority physician group and facility contracts using Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines. Emphasis on number or percentage of Membership in Value Based Relationship Contracts. • Develops and maintains provider contracts in 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. • Advises Network Provider Contract Specialists on negotiation of individual provider and routine ancillary contracts. • Maintains contractual relationships with significant/highly visible providers. • 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, legal and VP level engagement as required. • Educates internal customers on provider contracts. • Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers. • Participates with the management team and other committees addressing the strategic goals of the department and organization. • Participates in other contracting related special projects as directed. • Rarely travels within the state. Job Qualifications REQUIRED EDUCATION: Bachelor's Degree in a healthcare related field or an equivalent combination of education and experience. REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES: • 5-7 years contract-related experience in the health care field including, but not limited to, provider's office, managed care organization, or other health care environment. • 3+ years experience in provider contract negotiations in a managed healthcare setting ideally in negotiating different provider contract types, i.e. physician, group and hospital contracting, etc. • Working familiarity with various managed healthcare provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including but not limited to: Value Based Payment, fee-for service, capitation and various forms of risk, ASO, etc. PREFERRED EDUCATION: Master's Degree in a related field or an equivalent combination of education and experience PREFERRED EXPERIENCE: 3+ years in Provider Network contracting 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. #PJCorp #LI-AC1

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. 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. 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. 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.