Top 522 Educational leadership Jobs in Nebraska

Senior Representative, Health Plan Provider Relations - Remote Must reside in NE
Molina Healthcare —Nebraska
- $47,433.00 - $97,362.61 a year
- Full-time
- Remote
- Medical office experience
- Contracts
- Senior level
- Health insurance
10d
Learning Design Consultant
Gallup —Omaha, NE
- $100,000 - $130,000 a year
- Hybrid work
- 5 years
- Mid-level
- Office
- Health insurance
- Dental insurance
10d
Health Educator
Two Rivers Public Health Department —Kearney, NE
- $22.19 - $24.97 an hour
- Weekends as needed
- Background check
- Ability to walk for extended periods
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
Nurse Educator FT
Nebraska Hospital —Papillion, NE
- From $42 an hour
- Full-time
- Nursing
- RN License
- PALS Certification
- Health insurance
- Dental insurance
Quick Apply
Community Health Worker
Two Rivers Public Health Department —Kearney, NE
- $18.84 - $21.27 an hour
- Part-time
- Hybrid work
- Background check
- Ability to walk for extended periods
- HIPAA
- Health insurance
- Dental insurance
Quick Apply
Property Representative
FBL Financial Group, Inc. —Sidney, NE
- Driver's License
- Travel
- US work authorization
- Paid holidays
- Disability insurance
11d
Property Representative
FBL Financial Group, Inc. —Kearney, NE
- Driver's License
- Travel
- US work authorization
- Paid holidays
- Disability insurance
11d
CDL Instructor - $5,000 Hiring Bonus
Roadmaster Driver School —Omaha, NE
- Weekends as needed
- Classroom
- Pass drug screening
- CDL A
- AD&D insurance
- Employee stock purchase plan
Quick Apply
Catastrophe Claims Representative
FBL Financial Group, Inc. —Lincoln, NE
- Weekends as needed
- Mid-level
- 3 years
- Analysis skills
- Paid holidays
- Disability insurance
3d
Technology Systems Engineering Supervisor
Grand Island Casino Resort —Grand Island, NE
- From $75,000 a year
- Full-time
- Background check
- Computer science
- Computer Science
Quick Apply
Sr. Program Lead, Professional Education, CKMH
American Heart Association —Omaha, NE
- $84,400 - $113,000 a year
- Full-time
- Remote
- 5 years
- Bachelor's degree
- Fair chance
- Wellness program
- Paid holidays
Nebraska Educational Administrator/Leadership Coach
Bailey Education Group, LLC —Omaha, NE
- Contract
- Continuous improvement
- Math
- Senior level
Quick Apply
Instructional Designer I - REMOTE
Ryder System —Lincoln, NE
- $65,000 - $75,000 a year
- Remote
- Microsoft Excel
- Microsoft Outlook
- Organizational skills
- Disability insurance
- Health insurance
University of Nebraska-Lincoln – Nebraska Center for Research on Children, Youth, Families and Schools – Director and Full Professor
Lincoln, NE
- Online Application
- Doctoral degree
- University
- Children
Research Associate — Workplace Science
Gallup —Omaha, NE
- $90,000 - $110,000 a year
- Hybrid work
- Mid-level
- Office
- 3 years
- Health insurance
- Dental insurance
Part-Time Instructor
University of Nebraska at Omaha —Omaha, NE
- $3,500 a month
- Part-time
- Background check
- Classroom
- Bachelor of Science
University of Nebraska-Lincoln – Extension – Extension Instructor or Open Rank Extension Educator Livestock Systems (Brown County)
Ainsworth, NE
- Full-time
- Writing skills
- Master's degree
- University
Remote Documentation & Systems Coach Fellowship
LOVE JUSTICE INTERNATIONAL —Nebraska
- Part-time
- Remote
- School experience
- Mid-level
- Continuous improvement
Quick Apply
Statewide Eligibility Operations Administrator
State of Nebraska —Nebraska
- $44.58 an hour
- Full-time
- Office
- Finance
- Bachelor's degree
- Paid time off
Nebraska Teacher Consultant/Instructional Coach
Bailey Education Group, LLC —Omaha, NE
- Contract
- School experience
- Continuous improvement
- Math
Quick Apply

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Senior Representative, Health Plan Provider Relations - Remote Must reside in NE

Molina Healthcare -
Nebraska

Apply Now

Job Details

Full-time
$47,433.00 - $97,362.61 a year
10 days ago

Benefits

Health insurance

Qualifications

Customer training
Medicare
Managed care organization experience
Medical office experience
Educational talks
Schedule management
Corporate training teaching experience
Health insurance knowledge
Medicare regulations
Medicaid regulations
Medicaid
Productivity software
Healthcare reimbursement methods
Cross-functional collaboration
Cross-functional communication

Full Job Description

JOB DESCRIPTION Job SummaryProvides senior level 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 the plan's highest priority, high-volume and strategic complex community 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 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.
Resolves complex provider issues that may cross departmental lines and involve senior leadership.
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.).
Serves as a subject matter expert for the provider relations function.
Provides training and support to new and existing provider relations team members.
Role requires 80%+ same-day or overnight travel (extent of same-day or overnight travel will depend on the specific health plan service area).

Required Qualifications

At least 3 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.
Understanding of the health care delivery system, including government-sponsored health plans.
Understanding of 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.
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

Experience in provider services, operations, and/or contract negotiations in a Medicaid, Medicare, and/or Marketplace managed health care setting - ideally with different provider types (i.e. physician, group, hospital).

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: $47,433 - $97,362.61 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply Now

Refine Your Search

educational leadership jobs in nebraska

Senior Representative, Health Plan Provider Relations - Remote Must reside in NE

Learning Design Consultant

Health Educator

Nurse Educator FT

Community Health Worker

Property Representative

Property Representative

CDL Instructor - $5,000 Hiring Bonus

Catastrophe Claims Representative

Technology Systems Engineering Supervisor

Sr. Program Lead, Professional Education, CKMH

Nebraska Educational Administrator/Leadership Coach

Instructional Designer I - REMOTE

University of Nebraska-Lincoln – Nebraska Center for Research on Children, Youth, Families and Schools – Director and Full Professor

Research Associate — Workplace Science

Part-Time Instructor

University of Nebraska-Lincoln – Extension – Extension Instructor or Open Rank Extension Educator Livestock Systems (Brown County)

Remote Documentation & Systems Coach Fellowship

Statewide Eligibility Operations Administrator

Nebraska Teacher Consultant/Instructional Coach

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