Director, Provider Contracts – Dental Market Segment

Job Description

About the Role

Director, Provider Contracts / Dental Market Segment – REMOTE

Molina Healthcare Job ID 2027774

KNOWLEDGE/SKILLS/ABILITIES

Plans, organizes, staffs, and coordinates the Provider Contracts activities for contracts at a National Level. Works with direct management, senior leadership/management, Corporate, and staff to develop and implement standardized provider contracts and contracting strategies.

Monitors and reports network adequacy for Medicare and Medicaid services.

In conjunction with direct management and senior leadership, oversees development of provider contracting strategies, identifying those specialties and geographic locations on which to concentrate resources for purposes of establishing a sufficient network of Participating Providers to serve the health care needs of members and patients.

Advises in preparation and negotiations of provider contracts and oversee negotiation of contracts in concert with established company guidelines with physicians, hospitals, and other health care providers.

Utilizes standardized contract templates and Pay for Performance strategies.

Develops and maintains Reimbursement Tolerance Parameters (across multiple specialties/ geographies). Oversees the development of new reimbursement models in concert with direct management and senior leadership/management.

Communicates new strategies to corporate provider network leadership for input.

Utilize standardized system(s) to track contract negotiation activity on an ongoing basis throughout the year.

Participates on the management team and other committees addressing the strategic goals of the department and organization.

Oversees the maintenance of all Provider Contract templates. Works with Legal and Corporate Network Management as needed to modify contract templates to ensure compliance with all contractual and/or regulatory requirements.

Manages the relationship with area agencies and community provider partners to support and advance Plan initiatives.

Develops and implements strategies to comply with state, federal, NCQA, HEDIS initiatives and regulations.

JOB QUALIFICATIONS

Required Education

Bachelor’s Degree in a related field (Business Administration, etc.) or equivalent experience.

Required Experience

7+ years experience in Healthcare Administration, Managed Care, Provider Contracting and/or Provider Services.

Min. 2 years experience managing/supervising employees.

Preferred Education

Master’s Degree

Preferred Experience

6+ years in Provider Network contracting in Dental market segment.

Experience leading Provider Contract, Provider Data Management, and Provider Relations teams.

Dental Provider Contract experience.

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: $87,568.7 – $189,732.18 / 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.

Job Type: Full Time