Job DescriptionProvider Network Administration is responsible for the accurate and timely validation, analysis, maintenance, and governance of critical provider information across claims, credentialing, contracting, and provider network systems. This role serves as a hybrid position focused on supporting provider lifecycle management operations through data analysis, reporting, workflow optimization, system enhancements, and cross-functional coordination.
The role partners closely with Network Operations, IT, PMO, Product Owners, Compliance, and business stakeholders to support operational initiatives, identify process improvement opportunities, enhance reporting capabilities, and improve provider data quality and operational performance.
KNOWLEDGE/SKILLS/ABILITIES - Assisting in requirement gathering, providing solutions, training users in Salesforce, creating training material.
- Analyze provider-related operational, compliance, and system data to identify trends, risks, process gaps, and opportunities for improvement.
- Solution design for Front end user experience in Salesforce and content development for our website.
- Assist in workflow optimization and process improvement
- Generates and prepares provider-related data and reports in support of Network Management and Operations areas of responsibility (e.g., Provider Services/Provider Inquiry Research & Resolution, Provider Contracting/Provider Relationship Management).
- Provides timely, accurate generation and distribution of required reports that support continuous quality improvement of the provider database, compliance with regulatory/accreditation requirements, and Network Management business operations. Report examples may include: GeoAccess Availability Reports, Provider Online Directory (including ongoing execution, QA and maintenance of supporting tables), Medicare Provider Directory preparation, and FQHC/RHC reports.
- Perform data validation, reconciliation, and quality assurance activities across provider systems and downstream integrations.
- Develops and maintains documentation and guidelines for all assigned areas of responsibility.
JOB QUALIFICATIONS Required Education Bachelor's Degree or equivalent combination of education and experience
Required Experience - 3-5 years managed care experience, including 2+ years in Provider Claims and/or Provider Network Administration.
- 3+ years' experience in Salesforce User Interface is required.
- Experience in User Acceptance Testing is required (UAT).
- Access and Excel - intermediate skill level (or higher)
Preferred Education Bachelor's Degree
Preferred Experience - 5+ years managed care experience
- Crystal Reports for data extraction
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Never miss an opportunity! Create an alert based on the job you applied for.