–
(
165168
)
Remote
:
No
Primary Location
:
US-CA-Long Beach-MOLINA300
Job
:
Fusion
Organization
:
Health Plans
Job Type
:
Full-time
Job Posting
:
Jun 28, 2016, 12:11:29 PM
Knowledge/Skills/Abilities
- Direct supervision of Provider Service function, specifically Provider Services Representatives. Includes training, evaluation and performance monitoring of assigned employees to ensure superior provider network satisfaction.
- Responsible for oversight, delegation and prioritization of tasks and monitoring Provider inquiries.
- Responsible for ongoing team development and to communicate updates and enhancements to team regarding company policies.
- Ensures new office orientation meetings/presentations for newly contracted provider locations are completed.
- Assists with strategies to increase provider engagement in HEDIS and quality initiatives.
- Implements strategies to increase provider satisfaction scores.
- Engages contracted providers in cost control initiatives to positively influence the Medical Care Ratio.
- Maintains and keeps training materials up-to-date and well organized.
- Assists with all other monthly reporting activities.
- Resolves elevated Provider complaints and builds strong business relationships internally and externally.
- Researches issues and give administrative decisions regarding concerns and questions based on policies and procedures.
- Communicates effectively with internal departments to develop efficient processes and achieve cross-departmental goals.
Supervises Network Provider Services Department through delegation of duties and monitoring of daily operations, according to the department’s policies and procedures.• Working knowledge of Microsoft Office or other comparable software
- Ability to quickly assimilate concepts or to comprehend ideas and made effective management decisions accordingly
- Ability to be adaptable and flexible to change and respond to new ideas and approaches
- Good analytical skills
- Excellent time management and delegation skills
- Excellent interpersonal and verbal and written communication skills
- Ability to abide by Molina’s policies
- Ability to maintain attendance to support required quality and quantity of work
- Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
- Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers
Job Qualifications
Required Education
High School Diploma or equivalent GED
Required Experience
2 years Provider Services experience in a managed care setting.
Preferred Education
Associate’s/Bachelor’s Degree
Preferred Experience
Previous Provider Services experience in a leadership capacity.
Medical terminology.
CPT/HCPC and ICD-9 coding.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Also, fill out an Employee Transfer Notice Form (ETN) and attach it to your profile when applying online.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
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231 reviews
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