Top 602 Senior operations representative Jobs in Washington State

Senior Representative, Health Plan Provider Relations (Must Reside in WA)
Molina Healthcare —Washington State
- $83,252 - $111,967 a year
- Full-time
- Medical office experience
- Contracts
- Senior level
- Health insurance
Public Works Strategic Communications Specialist
City of Vancouver —Vancouver, WA
- $7,339 - $11,010 a month
- Full-time
- Marketing
- Customer service
- 5 years
Senior Program Officer, SmileMobile
Delta Dental of Washington —Seattle, WA
- $92,900 - $145,700 a year
- Hybrid work
- CPR Certification
- Writing skills
- HIPAA
- Dental insurance
- Tuition reimbursement
Senior Planner
City of Puyallup —Puyallup, WA
- $93,576 - $119,760 a year
- Weekends as needed
- Word processing
- Mid-level
- Office
- Wellness program
- Paid holidays
shared services senior manager, Customer Advocacy
Starbucks —Seattle, WA
- $112,900 - $169,500 a year
- 5 years
- Office
- Master's degree
- Paid parental leave
- Paid holidays
Senior General Counsel
Seattle Public Schools —Seattle, WA
- $167,835.20 - $215,508.80 a year
- Weekends as needed
- Background check
- 6 years
- Writing skills
Senior Program Manager-System Planning
Sound Transit —Seattle, WA
- $81,000 - $186,000 a year
- Hybrid work
- 5 years
- Research
- Office
- Commuter assistance
- Paid holidays
Senior People Operations Business Partner
The Allen Institute for Artificial Intelligence —Seattle, WA
- $119,520 - $179,280 a year
- Office
- Bachelor's degree
- Mentoring
- Health savings account
- Paid holidays
Senior Auto Glass Installation Technician - Remote - Seattle, WA
Auto Glass Now —Seattle, WA
- $22.50 - $38.60 an hour
- Full-time
- 18 years or older
- Mechanic experience
- Mid-level
- Health savings account
- Paid holidays
Senior Director, Life Science and Healthcare Services
KG Investment Properties, LLC —Bellevue, WA
- $150,000 - $200,000 a year
- Full-time
- Google Workspace
- Engineering
- 11+ years
- Mileage reimbursement
- Health savings account
Quick Apply
7d
Nurse Manager, Women's Health Clinic
3W Medical for Women —Seattle, WA
- $85,000 - $95,000 a year
- Full-time
- Hybrid work
- CPR Certification
- Nursing
- RN License
- Free parking
- Paid holidays
Quick Apply
Refrigeration Technician Assistant
Cowiche Growers, Inc —Cowiche, WA
- $19 - $24 an hour
- Full-time
- Clean driving record
- Computer literacy
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Inside Sales Representative
Intelligent Weighing Technology —Port Townsend, WA
- $68,000 - $80,000 a year
- Full-time
- Computer literacy
- Mid-level
- Office
- Paid time off
Quick Apply
9d
Data Center Project & Facilities Manager
Artemis Technologies —Wenatchee, WA
- $110,000 - $135,000 a year
- Full-time
- Construction site
- Mid-level
- Office
- Paid holidays
- Relocation assistance
Quick Apply
9d
Senior SBA Loan Coordinator
WaFd Bank —Seattle, WA
- $35.36 - $47.15 an hour
- Full-time
- Microsoft Excel
- 5 years
- Office
- Paid parental leave
- AD&D insurance
12d
Commercial Dock & Door Service Technician
Miner, LTD —Seattle, WA
- $20 - $35 an hour
- Overtime
- Clean driving record
- Mid-level
- Analysis skills
- Paid holidays
- Health insurance
Quick Apply
Project Manager
Zimmerman Associates, Inc. —Washington State
- Contract
- English
- Mid-level
- Bachelor's degree
Transportation Program Manager
Northshore Senior Center —Bothell, WA
- $29 - $32 an hour
- Full-time
- Background check
- CPR Certification
- Experience working with individuals with disabilities
- Health insurance
- Dental insurance
Quick Apply
Project Manager
Ballard Marine Construction —Washougal, WA
- $130,000 - $150,000 a year
- 7 years
- Construction site
- Mid-level
- Paid holidays
- Disability insurance
Quick Apply
Executive Director
Kiran Anjali Project —Seattle, WA
- $45,000 - $50,000 a year
- Part-time
- 3 years
- Organizational skills
- Senior level
- Paid holidays
- Paid time off

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senior operations representative jobs near washington state

Senior Representative, Health Plan Provider Relations (Must Reside in WA)

Molina Healthcare -
Washington State

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Job Details

Full-time
$83,252 - $111,967 a year

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
Cross-functional collaboration
Cross-functional communication
Staff development

Full Job Description

JOB DESCRIPTION Job Summary

Provides 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 10% 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: $83,252 - $111,967 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply Now

Refine Your Search

senior operations representative jobs in washington state

Senior Representative, Health Plan Provider Relations (Must Reside in WA)

Public Works Strategic Communications Specialist

Senior Program Officer, SmileMobile

Senior Planner

shared services senior manager, Customer Advocacy

Senior General Counsel

Senior Program Manager-System Planning

Senior People Operations Business Partner

Senior Auto Glass Installation Technician - Remote - Seattle, WA

Senior Director, Life Science and Healthcare Services

Nurse Manager, Women's Health Clinic

Refrigeration Technician Assistant

Inside Sales Representative

Data Center Project & Facilities Manager

Senior SBA Loan Coordinator

Commercial Dock & Door Service Technician

Project Manager

Transportation Program Manager

Project Manager

Executive Director

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