Director, Provider Data Management

Network Solutions Director

Job Summary : The Network Solutions Director is responsible for leading a team designing and executing new solutions. The position requires the ability to lead a diverse team of technical experts and business analysts. The Solutions Director will interface with IT and business leaders to enable enterprise wide capabilities. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.

Knowledge / Skills / Abilities :

• Strategically plans, leads, and manages the overall Provider Information process functions.
• Partner with stakeholders to creatively design solutions utilizing provider data such as the Provider Online Directory, Utilization Management, Customer Experience, Enrollment, and Claims Payment and Processing.
• Develop and enforce operating procedures for accurate and timely end to end solution delivery.
• Continuously evolve analytics program to measure effectiveness of current state solutions and identify opportunities for improvement.
• Lead engagement model with business stakeholders to shape solution design and delivery throughout delivery timeline.
• Create presentation materials for executive leaders on conceptual and finalized design models.
• Supports critical business strategies by providing systematic solutions and or recommendations on business processes. Engages with IT and other departments to implement changes to business processes and systems for Corporate Operations PMO.

Job Qualifications :

Required Education : Graduate Degree or equivalent combination of education and experience

Required Experience : 7-9 years Provider Data

Preferred Education : Graduate Degree or equivalent combination of education and experience

Preferred Experience : 10+ years Provider Data

To all current Molina employees : If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M / F / D / V.