Health Plan Provider Relations Manager (WI State Health Plan)

Job description

JOB DESCRIPTION: ****Employee for this role must reside in Wisconsin****** 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. The Manager is responsible for provider engagement, contract negotiation, issue resolution, and education while ensuring compliance with all applicable federal, state, and local regulations. Essential Job Duties: - 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 coordination and partnership between the health plan and contracted providers. - Serves as the primary poin...