Supervisor, Dental Provider Services

Position Overview

Leads and supervises team responsible for enterprise network management and operations activities including 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.

Anticipated start date: March 2026.

Key Responsibilities

• Oversees national Molina network management and operations function and team, including daily departmental operations and provider services activities such as education, outreach, and resolving provider inquiries.
• Develops and deploys strategic network planning tools to drive provider services and contracting strategy across the enterprise.
• Facilitates strategic planning and documentation of network management standards and processes.
• Develops standards and resources to help Molina health plans develop and refine cost-effective, high-quality strategic provider networks and establish long-term partnerships.
• Collaborates with health plan network leadership, operations teams, and business unit stakeholders to support provider services functions and strategic initiatives with best practices.
• Oversees national network management and operations provider contracting strategies by identifying specialties and geographic concentrations to ensure a sufficient network of providers.
• Leads external provider representative functions, including policy development, training material preparation, and reporting to meet standards.
• Assists with enterprise-wide provider network development and educates contracted providers regarding health plan procedures and claims payment policies.
• Develops and implements tracking tools for timely issue resolution and compliance with network standards.
• Oversees timely intervention and communication for provider issues and complaints (e.g. claims data, eligibility, reimbursement, and provider website concerns).
• Serves as a resource to support health plan initiatives and ensures compliance with regulatory requirements and strategic goals.
• Ensures effective cross-departmental communication regarding provider network initiatives and issues.
• Designs and implements programs to foster positive relationships among contracted providers, ancillary providers, hospital facilities, and health plans.
• Develops enterprise-wide strategies to enhance provider participation in HEDIS and quality initiatives.
• Provides matrixed team support including provider/contract support services, resolution support, and contract management support services.
• Creates and delivers provider communications, training, and education programs for internal staff and external stakeholders.
• Implements strategies to reduce member access grievances with contracted providers.
• Engages contracted network providers regarding cost-control initiatives, MCR, non-emergent utilization, and CAHPS to influence future trends positively.
• Ensures compliance with company/plan business requirements, statutory requirements, government program standards, and network access standards.
• Hires, trains, manages, and evaluates team members, providing coaching, development, recognition, and ensuring continuous staff training and collaborative communication.

Required Qualifications

• At least 5 years of provider services experience supporting individual/group providers, hospitals, integrated delivery systems, or ancillary providers with Medicaid, Medicare, and/or Marketplace products, or equivalent relevant experience.
• Understanding of the health care delivery system, including government-sponsored health plans.
• Experience with various managed health care provider compensation methodologies (e.g. fee-for-service, capitation, risk-based models, ASO, etc.).
• Previous experience working with community agencies and providers.
• Strong organizational skills and meticulous attention to detail.
• Ability to manage multiple tasks and deadlines effectively.
• Excellent interpersonal skills with the ability to interface with providers and medical office staff.
• Experience in preparing and presenting formal presentations.
• Project management experience.
• Ability to work in a cross-functional, highly matrixed organization.
• Effective verbal and written communication skills.
• Proficiency in Microsoft Office suite and related software programs.

Preferred Qualifications

• Management/leadership experience.
• Contract negotiation experience.

Benefits & Perks

• Compensation & Benefits: Molina Healthcare offers a competitive benefits and compensation package.
• Pay Range: $80,168 - $128,519 / ANNUAL (Actual compensation may vary based on geographic location, work experience, education and/or skill level.)
• Employment Type: Full Time

Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

To current Molina employees: Please apply through the intranet job listing.