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Job Field: Legal Jobs
Location: Long Beach, CA
Salary: $48,000 to 58,000/year, depending on experience

JOB SUMMARY:

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<tr><td valign="top" width="450"><b>JOB SUMMARY
Negotiates assigned contracts and letters of agreements with hospitals, physician groups and ancillary providers that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according to departmental procedures.
ESSENTIAL FUNCTIONS
Duties and Responsibilities
Initiates, negotiates, generates and tracks provider Letters of Agreement, contracts and amendments from initial draft to full execution utilizing approved standardized contract templates/amendments.
Supports network development throughout state to including researching, recruiting and negotiating with providers.
Participates in the evaluation of provider network and implementation of strategic plans to meet Molinas network adequacy standards.
Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers.
Assists in analysis and coordination of amendments, reimbursement, and language changes.  Requests information of billing codes, services provided and other information needed to complete the contract profile.
Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes.
Travels regularly throughout designated regions to meet targeted needs.
Other duties as assigned
Knowledge, Skills and Abilities
Knowledge in Excel, Word, Outlook, and PowerPoint programs
Ability to interact well with all internal and external customers
Ability to work and make decisions independently
Excellent organizational and verbal and written communication skills
Ability to abide by Molinas policies
Ability to maintain attendance to support required quality and quantity of work
Maintain confidentiality and comply with Health Insurance Portability and Accountability Act HIPAA
Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers
QUALIFICATIONS
Required Education
Bachelors Degree or equivalent work experience in health care field including, but not limited to, providers office, managed care, or other health care field.
Preferred Education
Bachelors Degree
Required Experience
5 years provider contract negotiation experience in the health care field including, but not limited to, providers office, managed care organization, or other health care field.

KEY REQUIREMENTS:

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4 years High School/GED