Top 206604 Education services representative Jobs

Representative, Health Plan Provider Relations - Remote Must reside in NY
Molina Healthcare —New York, NY
- $19.84 - $46.42 an hour
- Full-time
- Remote
- Medical office experience
- Mid-level
- Travel
- Health insurance
Specialist/Teacher
Jobs for Nevada's Graduates —Fallon, NV
- Up to $47,503 a year
- Full-time
- Microsoft Word
- Classroom
- Microsoft Excel
- Health insurance
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FT Licensed Mental Health Practitioner Chico, CA
Compassion Services —Chico, CA
- $56,230 - $81,780 a year
- Weekends as needed
- LMFT
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9d
Part-Time EAP Professional - LICENSED - (5+ year experience required)
eni —Goldsboro, NC
- $40 an hour
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- 5 years
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- 401(k)
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Massage Therapist
The Otesaga Resort Hotel —Cooperstown, NY
- $45 - $65 an hour
- 8 hour shift
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Clinical Liaison
Chesterfield County Health Center —Chesterfield, VA
- Full-time
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- RN License
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Special Education Teacher / Education Specialist - Mild/Mod - Middle School (26-27)
KIPP Public Schools Northern California —San Jose, CA
- Full-time
- Classroom
- CPR Certification
- Google Workspace
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NEI - 26-27 SY Middle/High School Art Teacher
Noble Education Initiative, Inc. —Antioch, TN
- From $52,000 a year
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- Health insurance
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Bilingual Float Patient Service Representative
Carolina Health Centers, Inc. —Greenwood, SC
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- Clean driving record
- Microsoft Excel
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Senior Major Gift Officer, and Director of Alumni Relations
University of Saint Mary of the Lake —Mundelein, IL
- $85,000 - $130,000 a year
- Full-time
- Microsoft Outlook
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Licensed Veterinarian
Elm Point Animal Hospital —Saint Charles, MO
- Full-time
- Sanitation
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Roman Catholic Diocese of Las Cruces —Las Cruces, NM
- From $50,000 a year
- Weekends as needed
- Microsoft Word
- Microsoft Excel
- Research
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9d
Insurance Customer Service Representative
Local Independent Insurance Agency —O'Fallon, IL
- $18 - $24 an hour
- Part-time
- Background check
- Mid-level
- Office
- Paid holidays
- Paid time off
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Veterinary Technician Surgery
Bridger Veterinary Specialists, Bozeman Montana —Bozeman, MT
- $25 - $31 an hour
- Multiple hires
- Background check
- Customer service
- Mid-level
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- Paid holidays
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Special Education Teacher / Education Specialist - Mild/Mod - High School (26-27)
KIPP Public Schools Northern California —San Jose, CA
- Full-time
- School experience
- Classroom
- CPR Certification
- Commuter assistance
- Health insurance
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Electronic Resources Librarian (ERL)
University Of Saint Mary of the Lake —Mundelein, IL
- $53,000 - $75,000 a year
- Full-time
- Microsoft Excel
- Mid-level
- Master's degree
- Health savings account
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10d
Rochester Men's Client Care Specialist
MN Adult & Teen Challenge —Rochester, MN
- $19 an hour
- 8 hour shift
- Clean driving record
- Vital signs
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Career Services Adviser
Intellitec College —Colorado Springs, CO
- $20 - $23 an hour
- Full-time
- Classroom
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Teacher II EHS- Young Innovators
Pacific Asian Consortium in Employment (PACE) —Los Angeles, CA
- $26.76 an hour
- Full-time
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- Health savings account
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Massage Therapist at Luxury Hotel
LAFAYETTE PARK HOTEL & SPA —Lafayette, CA
- $16.90 - $35.00 an hour
- Full-time
- CPR Certification
- Anatomy knowledge
- BLS Certification
- Health insurance
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Quick Apply

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Representative, Health Plan Provider Relations - Remote Must reside in NY

Molina Healthcare -
New York, NY

Apply Now

Job Details

Full-time
$19.84 - $46.42 an hour

Benefits

Health insurance

Qualifications

Customer communication
Managed care
Managed care organization experience
Medical office experience
Schedule management
Health insurance knowledge
Productivity software
Cross-functional collaboration
Cross-functional communication

Full Job Description

JOB DESCRIPTION Job Summary

Provides support 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

Successfully engages high-volume, high-visibility plan providers, 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 point of contact between Molina health plan and the non-complex provider community that services Molina members, including but not limited to fee-for-service (FFS) and pay-for-performance (P4P) providers.
Collaborates directly with the plan’s external providers to educate, advocate and engage as valuable partners - ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service; effectively drives timely issue resolution, electronic medical record (EMR) connectivity, and provider portal adoption.
Conducts regular provider site visits within assigned region/service area; determines daily or weekly schedule, to meet or exceed the plan's monthly site visit goals. Proactively engages with the provider and staff to determine; for example, non-compliance with Molina policies/procedures or Centers for Medicare and Medicaid Services (CMS) guidelines/regulations, or to assess the non-clinical quality of customer service provided to Molina members.
Provides on-the-spot training and education as needed, including counseling providers diplomatically, while retaining a positive working relationship.
Independently troubleshoots provider problems as they arise, and takes initiative in preventing and resolving issues between the provider and the plan whenever possible. The types of questions, issues or problems that may emerge during visits are unpredictable and may range from simple to very complex or sensitive matters.
Initiates, coordinates and participates in problem-solving meetings between the provider and Molina stakeholders, including senior leadership and physicians (examples include: issues related to utilization management, pharmacy, quality of care, and correct coding).
Independently delivers training and presentations to assigned providers and their staff - answering questions that come up on behalf of the health plan; may also deliver training and presentations to larger groups, such as leaders and management of provider offices, including large multispecialty groups or health systems, executive level decision makers, association meetings, and joint operating committees (JOCs).
Performs an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives; examples of such initiatives include: administrative cost-effectiveness, member satisfaction - Consumer Assessment of Healthcare Providers and Systems (CAHPS), regulatory-related, Molina quality programs, and taking advantage of electronic solutions (electronic data interchange (EDI), EMR, provider portal, provider website, etc.).
May provide training and support to new and existing provider relations team members as appropriate.

will require to travel at least once a week subject to change.

Required Qualifications

At least 2 years of customer service, provider services, or claims experience in a managed care or medical office setting, or equivalent combination of relevant education and experience.
General understanding of the health care delivery system, including government-sponsored health plans.
Organizational skills and attention to detail.
Ability to manage multiple tasks and deadlines effectively.
Interpersonal skills, including ability to interface with providers and medical office staff.
Ability to work in a cross-functional highly matrixed organization.
Effective verbal and written communication skills.
Microsoft Office suite and applicable software programs proficiency.

Preferred Qualifications

Familiarity with various managed health care provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including: fee-for service (FFS), capitation and various forms of risk, ASO, etc.
Experience delivering training and facilitating educational presentations.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $19.84 - $46.42 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply Now

Refine Your Search

education services representative jobs

Representative, Health Plan Provider Relations - Remote Must reside in NY

Specialist/Teacher

FT Licensed Mental Health Practitioner Chico, CA

Part-Time EAP Professional - LICENSED - (5+ year experience required)

Massage Therapist

Clinical Liaison

Special Education Teacher / Education Specialist - Mild/Mod - Middle School (26-27)

NEI - 26-27 SY Middle/High School Art Teacher

Bilingual Float Patient Service Representative

Senior Major Gift Officer, and Director of Alumni Relations

Licensed Veterinarian

Annual Giving and Stewardship Coordinator

Insurance Customer Service Representative

Veterinary Technician Surgery

Special Education Teacher / Education Specialist - Mild/Mod - High School (26-27)

Electronic Resources Librarian (ERL)

Rochester Men's Client Care Specialist

Career Services Adviser

Teacher II EHS- Young Innovators

Massage Therapist at Luxury Hotel

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