Behavioral Health Plan Provider Relations Manager

Job description

JOB DESCRIPTION: ****Employee for this role must reside in the state of Illinois*** Job Summary: Provides subject matter expertise and leadership for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers within the Molina network. Responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina policies and procedures. Essential Job Duties: - Supporting Behavioral Health providers, including Community Mental Health Centers (CMHCs), SUPR-certified providers, and other BH organizations. - Behavioral Health billing practices, common claim issues, coding requirements, and operational challenges faced by BH providers. - Successfully engages the plan's highest priority, high-volume and strategic complex provider community providers (including value-based payment (VBP) and other alternative payment method (APM) contracts to ensure provider satisfaction, facilitate education on key Molina initiatives, and improve coordinatio...