Program Manager, Provider Data Config NM Medicaid Remote

Job description

Molina of New Mexico is hiring for a Program Manager, Provider Data Config. This position is remote, however qualified candidates will have in-depth knowledge of New Mexico Medicaid operations. This role is critical to maintaining provider data accuracy, overseeing audits, and supporting configuration activities that directly impact claims adjudication and provider payment. Highly qualified candidates will have the following experience- - Strong understanding of New Mexico Medicaid operations - Experience with QNXT - Prior Provider Data Management (PDM) experience - Audit and configuration experience preferred - PDM and QNXT experience - Strong organizational skills - Attention to detail Job Summary: This role supports accurate provider data and claims configuration to ensure providers are paid correctly and members experience seamless access to care This position sits within Operations and supports the Medicaid, Marketplace and Medicare line of businesses. Key responsibilities include Health Plan Provider Data Management, provider data audits, and system configuration to ensure accurate provider information and claims processing Provides support to Molina functional areas through...