# Health Plan Provider Relations Manager (Remote in IL) Remote from[USA](https://jobicy.com/job-region/usa.md)Annual salary Undisclosed Salary information is not provided for this position. Check our [Salary Directory](https://jobicy.com/salaries.md) to estimate the average compensation for similar roles.Department [Customer Success](https://jobicy.com/categories/supporting.md) Employment type Full Time, Job posted23 Jun 2026Apply before23 Jul 2026Experience level Senior Views / Applies 1567 / 126 [About company](https://jobicy.com/company/molina-healthcare.md) * Share About [Molina Healthcare](https://jobicy.com/company/molina-healthcare.md) Molina Healthcare is a FORTUNE 500, multi-state health care organization. [Hospital & Health Care](https://jobicy.com/company-category/hospital-health-care.md) * 1980 Actively Hiring Verified job posting This job post has been [manually reviewed](https://jobicy.com/tools/help-center/employee/how-does-jobicy-verify-the-legitimacy-of-remote-job-listings.md) for authenticity and compliance. ### AI Summary This role involves managing provider relations for a health plan, serving as the primary point of contact for contracted providers. Responsibilities include network management, provider education, issue resolution, and training. The position requires independent troubleshooting and collaboration with internal stakeholders to ensure compliance and satisfaction. It offers a remote opportunity based in Illinois, with a focus on strategic provider engagement and value-based payments. ### Role DNA Job Complexity Easy Hard Pace & Pressure Relaxed Fast-paced Autonomy Level Guided Full Ownership Communication Load Independent Highly Collaborative AI Insight The job requires extensive knowledge of healthcare provider networks, compliance, and complex issue resolution, making it challenging but manageable with experience. ### Salary Analysis Median Market Rate $85,000US Market $60k – 130k 0 $143k AI Insight The salary was not provided in the listing. Based on market data for Provider Relations Managers in the US health insurance sector, the median salary is estimated at $85,000, with a typical range from $60,000 to $130,000. This role's compensation should be competitive considering the level of autonomy and expertise required. ### Core Skills Required [Provider Relations](https://jobicy.com/jobs?search_keywords=Provider+Relations.md) [Network Management](https://jobicy.com/jobs?search_keywords=Network+Management.md) [Healthcare Compliance](https://jobicy.com/jobs?search_keywords=Healthcare+Compliance.md) [Provider Education](https://jobicy.com/jobs?search_keywords=Provider+Education.md) [Contract Negotiation](https://jobicy.com/jobs?search_keywords=Contract+Negotiation.md) [Issue Resolution](https://jobicy.com/jobs?search_keywords=Issue+Resolution.md) [CRM](https://jobicy.com/jobs?search_keywords=CRM.md) [Medicare/Medicaid](https://jobicy.com/jobs?search_keywords=MedicareMedicaid.md) [Data Analysis](https://jobicy.com/jobs?search_keywords=Data+Analysis.md) [Presentation Skills](https://jobicy.com/jobs?search_keywords=Presentation+Skills.md) ### Cover Letter Sample Dear Hiring Manager, I am excited to apply for the Health Plan Provider Relations Manager position. With over 8 years of experience in network management and provider relations within managed care, I have a proven track record of enhancing provider satisfaction and compliance. I am skilled in resolving complex issues, delivering training, and driving value-based payment initiatives. My background includes developing strategic relationships with high-volume providers and leading cross-functional problem-solving. I am adept at independently managing site visits and ensuring adherence to CMS guidelines. I thrive in fast-paced environments and am passionate about improving healthcare delivery through effective provider partnerships. I look forward to the opportunity to contribute to Molina Healthcare's network excellence. Thank you for your consideration. Sincerely, [Your Name] Copy ### Sample Interview Questions Describe your experience with value-based payment models and how you educate providers on them.I have worked extensively with VBP models, including bundled payments and shared savings. I create tailored training materials and conduct one-on-one sessions to explain quality metrics and financial incentives. I also provide ongoing support to address provider concerns and ensure alignment with goals.How do you handle a provider who is non-compliant with Molina policies?I first conduct a site visit to understand the root cause. Then, I provide targeted training and resources, documenting the interaction. If non-compliance persists, I escalate to leadership while maintaining a collaborative approach to avoid relationship damage.Can you give an example of a complex provider issue you resolved that involved multiple departments?At my previous job, a provider had persistent claims denials due to coding errors. I coordinated with contracting, finance, and quality teams to identify system issues. We implemented a correction, and I provided on-site training, reducing denials by 40%.How do you prioritize site visits and provider outreach in a large service area?I use a data-driven approach, focusing on high-volume providers, those with low satisfaction scores, or issues. I also allocate time based on contract value and regulatory requirements. Monthly goals help ensure productivity, and I adapt based on emerging needs.How do you stay updated on CMS and state regulations affecting provider relations?I subscribe to CMS updates, attend webinars, and participate in internal training. I also collaborate with compliance teams to interpret changes and incorporate them into provider communications and training materials. JOB DESCRIPTION Job Summary Provides subject matter expertise and leadership 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 provider community providers (including value-based payment (VBP) and other alternative payment method (APM) contracts 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 for 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. • Resolves complex provider issues that may cross departmental lines including contracting, finance, quality, operations, and may 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.). • Oversees and demonstrates accountability for provider satisfaction survey results. • Develops and deploys strategic network planning tools to drive provider relations and contracting strategy across the enterprise. • Facilitates strategic planning and documentation of network management standards and processes (effectiveness is tied to financial and quality indicators). • Works collaboratively with functional business unit stakeholders to lead and/or support various provider services functions with an emphasis on developing and implementing standards and best practice sharing across the organization. • Navigates the matrix team environment including: new markets provider/contract support services, resolution support, and national contract management support services. • Serves as a subject matter expert for the provider relations function. • Provides training, mentoring, 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 6 years of provider services experience, including experience supporting individual/group providers, hospitals, integrated delivery systems, and ancillary providers with Medicaid, Medicare, and or Marketplace products, or equivalent combination of relevant education and experience. • Strong understanding of the health care delivery system, including government-sponsored health plans. • Experience 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. • Previous experience with community agencies and providers. • Strong organizational skills and attention to detail. • Ability to manage multiple tasks and deadlines effectively. • Experience with preparing and presenting formal presentations. • Strong interpersonal skills, including ability to interface with providers and medical office staff. • Ability to work in a cross-functional highly matrixed organization. • Strong verbal and written communication skills. • Microsoft Office suite and applicable software programs proficiency. Preferred Qualifications • Management/leadership experience. • Contract negotiation experience. 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 Show more [Apply now >](https://jobicy.com/jobs/147554-health-plan-provider-relations-manager-remote-in-il.md) > Annual salary information is not provided for this position. 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