Sr Specialist, Provider Network Admin- Remote CA
Long Beach, California
Employer: Molina Healthcare
Industry:
Salary: $66560 - $88511.4 per year
Job type: Full-Time
JOB DESCRIPTION
Candidate must reside in CA *****
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
JOB QUALIFICATIONS
Required Education
Bachelor's Degree or equivalent combination of education and experience
Required Experience
Preferred Education
Bachelor's Degree
Preferred 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: $66,560 - $88,511.46 / 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
Posting Date: 06/27/2024
Candidate must reside in CA *****
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
- 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.
- Generates other provider-related reports, such as: claims report extractions; regularly scheduled reports related to Network Management (ER, Network Access Fee, etc.).; and mailing label extract generation.
- 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 Medical Terminology, CPT, ICD-9 codes, etc.
- Access and Excel - intermediate skill level (or higher)
Preferred Education
Bachelor's Degree
Preferred Experience
- 5+ years managed care experience
- QNXT; SQL experience
- Crystal Reports for data extraction
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: $66,560 - $88,511.46 / 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
Posting Date: 06/27/2024
Created: 2024-08-22
Reference: 2026768
Country: United States
State: California
City: Long Beach
ZIP: 90822
Similar jobs:
-
Bilingual Community Relations Specialist (Remote - Southern CA based)
Aveanna Healthcare in Woodland Hills, California -
Remote CSR - Arabic, Farsi, Armenian, Russian, Mandarin or Cantonese (CA Only)
RemX in Oakland, California💸 $21.65 - $22.65 per hour -
Remote Full Time Licensed Therapist CA
UnitedHealth Group in San Diego, California💸 $58300 - $114300 per year -
Clinical Administrative Coordinator - Remote in Chatsworth, CA
UnitedHealth Group in Chatsworth, California💸 $16.54 - $32.55 per hour -
Bilingual Community Relations Specialist (Remote - Southern CA)
Aveanna Healthcare in Woodland Hills, California -
Utilization Management Phone Representative - Remote in Redlands, CA
UnitedHealth Group in Redlands, California💸 $16.00 - $28.27 per hour -
Remote CSR - Arabic, Farsi, Armenian, Russian, Mandarin or Cantonese (CA Only)
RemX in Oakland, California💸 $21.65 - $22.65 per hour -
Senior Government Funding Program Administrator - Must Reside in Sacramento or San Joaquin Valley, CA - Remote Opportunity
Kinder Care Education in California, California -
Claims Representative Senior - Remote in CA OR NV
UnitedHealth Group in Los Angeles, California💸 $19.47 - $38.08 per hour -
Associate Enroll/Eligibility Representative - Remote in Ontario, CA
UnitedHealth Group in Ontario, California💸 $16.00 - $28.27 per hour -
Senior Manager Operations - CA Remote
UnitedHealth Group in El Segundo, California💸 $88000 - $173200 per year -
End-User Computing Engineer (John Muir) - Remote in Walnut Creek, CA
UnitedHealth Group in Walnut Creek, California💸 $70200 - $137800 per year -
Bilingual Community Relations Specialist (Remote - Northern CA Based)
Aveanna Healthcare in Sacramento, California -
Behavioral Care Advocate, CA - After Hours - Remote
UnitedHealth Group in Los Angeles, California💸 $58300 - $114300 per year -
Trust and Estate Litigation Paralegal (Remote - CA based)
Boutique Recruiting in Irvine, California💸 $25 - $60 per hour -
Remote Subsidy Tuition Coordinator I - Must Reside In CA
Kinder Care Education in Riverside, California💸 $19.59 - $20.83 per hour -
RN Case Manager - Remote in CA
UnitedHealth Group in Irvine, California💸 $28.03 - $54.95 per hour -
Associate Vice-President, Provider Network Contracting - Remote in CA
UnitedHealth Group in Cypress, California💸 $234700 per year -
Key Accounts Senior Account Executive - Remote in San Francisco, San Jose or Sacramento, CA
UnitedHealth Group in San Francisco, California -
Senior Sales Consultant - Brands+ - Remote in Southern CA
UNFI in Los Angeles, California