Overview
Remote
On Site
Full Time
Skills
Database
System Requirements
Network Administration
Policies and Procedures
Business Systems
Supervision
Network
QNXT
SQL
Crystal Reports
Data Extraction
Microsoft Excel
Intranet
Health Care
Job Details
Job Description
Job Description
Job Summary
Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts.
Knowledge/Skills/Abilities
Manages all aspects of the Provider Administration area and serves as contact point for all configuration issues to ensure processes are carried out timely and accurately.
Establishes, maintains and analyzes internal standard operating policies and procedures pertaining to department functions.
Produces reports related to provider network information.
Collaborates with local and corporate departments on issues related to provider loads including, but not limited to, Configuration, Business Systems, Encounters (inbound and outbound), Claims, Provider Services and Contracting.
Identifies issues, resolves problems and implements best practices..
Job Qualifications
Required Education
Bachelor's Degree or equivalent combination of education and experience
Required Experience
5-7 years managed care experience, including min. 2 years of supervisory experience
Min. 2 years health plan Provider Network experience
Required License, Certification, Association
N/A
Preferred Education
Bachelor's Degree
Preferred Experience
7+ years managed care experience
QNXT; SQL experience
Crystal Reports for data extraction
Access and Excel - intermediate plus skill level
Preferred License, Certification, Association
N/A
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.
Job Description
Job Summary
Provider Network Administration is responsible for the accurate and timely validation and maintenance of critical provider information on all claims and provider databases. Staff ensure adherence to business and system requirements of internal customers as it pertains to other provider network management areas, such as provider contracts.
Knowledge/Skills/Abilities
Manages all aspects of the Provider Administration area and serves as contact point for all configuration issues to ensure processes are carried out timely and accurately.
Establishes, maintains and analyzes internal standard operating policies and procedures pertaining to department functions.
Produces reports related to provider network information.
Collaborates with local and corporate departments on issues related to provider loads including, but not limited to, Configuration, Business Systems, Encounters (inbound and outbound), Claims, Provider Services and Contracting.
Identifies issues, resolves problems and implements best practices..
Job Qualifications
Required Education
Bachelor's Degree or equivalent combination of education and experience
Required Experience
5-7 years managed care experience, including min. 2 years of supervisory experience
Min. 2 years health plan Provider Network experience
Required License, Certification, Association
N/A
Preferred Education
Bachelor's Degree
Preferred Experience
7+ years managed care experience
QNXT; SQL experience
Crystal Reports for data extraction
Access and Excel - intermediate plus skill level
Preferred License, Certification, Association
N/A
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.
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.