Provider Contracts Manager (Dental)
Company: Molina Healthcare
Posted on: November 13, 2023
***Remote and must live in Nebraska or a boarding state***
Negotiates agreements with highly visible providers who are
strategic to the success of the Plan, including integrated delivery
systems, hospitals and physician groups that result in high
quality, cost effective and marketable providers.
- In conjunction with Director/Manager Provider Contracts,
negotiates high priority physician group and facility contracts
using Preferred, Acceptable, Discouraged, Unacceptable (PADU)
- Develops and maintains provider contracts in APTTUS contract
- Targets and recruits additional providers to reduce member
- 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
- Maintains contractual relationships with significant/highly
- Advises Network Provider Contract Coordinators and Specialists
on negotiation of individual provider and routine ancillary
- 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
- Educates internal customers on provider contracts.
- Participates on the management team and other committees
addressing the strategic goals of the department and
Bachelor's Degree in a healthcare related field or an equivalent
combination of education and experience.
To all current Molina employees: If you are interested in applying
for this position, please apply through the intranet job
Molina Healthcare offers a competitive benefits and compensation
package. Molina Healthcare is an Equal Opportunity Employer (EOE)
Pay Range: -$66,456.22 - $129,589.63 a year*
*Actual compensation may vary from posting based on geographic
location, work experience, education and/or skill level
Keywords: Molina Healthcare, Independence , Provider Contracts Manager (Dental), Executive , Independence, Missouri
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