188,599 Nursing Care jobs in the United States
Recreation Therapist - Skilled Nursing Care

Posted 5 days ago
Job Viewed
Job Description
Evaluates the functional ability of patients through assessment of resident's skills (by clinical observation, interpretation of standardized tests, and patient/family interview). Creates individualized treatment plans, re-evaluates procedures, documents progress and completes written reports for quarterly and annual meetings. Consults with medical team, health professionals, family and school staff to render an individual intervention plan. Trains staff through formal in-services and direct, hands-on training. Coordinates all Recreational activities and the volunteer program, as well as maintains safe transportation services, operation of wheelchair vehicles and working with community groups.
MINIMUM QUALIFICATIONS:
Bachelor's Degree in Area of Study in a Field Related to the Position
1 year of experience
Recreational Therapist Certification
BLS for Healthcare Providers, issued by AHA
CA Driver's License (For Helen Bernardy Recreation Therapist Only)
Auto Insurance (If Driving Personal Vehicle, Helen Bernardy Recreation Therapist Only)
Leadership ability in both professional and interpersonal relationships
PREFERRED QUALIFICATIONS:
2 year of experience
Experience working with people with disabilities (Special Olympics, camp, school)
The current salary range for this position is $29.48 to $40.55
Rady Children's Hospital is committed to compensation that is externally competitive and internally equitable. We demonstrate this commitment by conducting regular market reviews to remain competitive with organizations of similar size in the nonprofit, healthcare sector. The range listed above does not represent the full salary range for the position but is the expected hiring range for qualified candidates. Compensation decisions consider a variety of factors including experience, education, licensure, unique skillsets, organizational need, and internal equity. This posting will remain open from the "date posted" until the hiring manager has determined there is a sufficient applicant pool or until the position is filled.
EOE including disability/vet
Clinical Activities Assistant - Skilled Nursing Care
Posted 3 days ago
Job Viewed
Job Description
Work with clinical team to manage resident education plans, equipment, services & appointments, including transportation. Participate as an active member of the Interdisciplinary Team providing input on appointments, programs, equipment & services. Work as a CNA to provide direct patient care when requested.
MINIMUM QUALIFICATIONS:
H.S. Diploma,GED,or Equivalent
3 Years of Experience
BLS for Health Providers (AHA)
CA Driver's License
Certified Nursing Assistant
The current salary range for this position is $22.00 to $30.27
Rady Children's Hospital is committed to compensation that is externally competitive and internally equitable. We demonstrate this commitment by conducting regular market reviews to remain competitive with organizations of similar size in the nonprofit, healthcare sector. The range listed above does not represent the full salary range for the position but is the expected hiring range for qualified candidates. Compensation decisions consider a variety of factors including experience, education, licensure, unique skillsets, organizational need, and internal equity. This posting will remain open from the "date posted" until the hiring manager has determined there is a sufficient applicant pool or until the position is filled.
EOE including disability/vet
Clinical Nurse (RN) - Skilled Nursing Care (Bernardy)

Posted 5 days ago
Job Viewed
Job Description
JOB SUMMARY:
Responsible for independently applying the nursing process through the assessment, planning, implementation, evaluation & documentation of pediatric patient care. Selects & administers the appropriate care, taking into consideration the age, developmental level & size of the patient. Provides a caring relationship that facilitates health, healing & quality of life. Able to identify own limitations & seeks resources, as needed. Acts as role model & resource person providing clinical leadership to other staff members & ensures quality clinical practices, skills, & developmentally appropriate activities for the residents.
MINIMUM QUALIFICATIONS:
Associate's Degree
1 year of experience
Current California RN license
BLS for Healthcare Providers, issued by AHA
PEARS (AHA) within 6 months of hire
PREFERRED QUALIFICATIONS:
Bachelor's Degree in Nursing
2 years of experience
Minimum one year of supervisory experience
Experience working with ventilator-dependent children and children with developmental disabilities
The current salary range for this position is $51.22 to $84.62
A candidate's placement in the range will be determined based on the terms and conditions of the applicable collective bargaining agreement. Rady Children's Hospital is committed to being externally competitive and internally equitable. We demonstrate this commitment by reviewing market data to remain competitive within the nonprofit, healthcare sector.
EOE including disability/vet
Provider Contracts Manager (Skilled Nursing & Care Coordination)
Posted 2 days ago
Job Viewed
Job Description
**Job Description**
**Job Summary**
Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations.
Responsible for contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and JOCs on exception, including standardized fee for service and other core payment method contracts with predefined, common programs.
Typically does not entail heavy negotiations. Minimal ongoing engagement after contract. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when applicable, and the 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.
**Job Duties**
This role negotiates assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according to departmental procedures. Contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and Joint Operating Committees on exception.
- Initiates, negotiates, generates and tracks provider Letters of Agreement, contracts and amendments from initial draft to full execution utilizing approved standardized contract templates/amendments, including but not limited to Fee for Service and Basic Alternative Payment Methods including Pay for Performance.
- Assesses and negotiates contract language for ancillary providers including, but not limited to Behaviorial Health, Home Health, Hospice, Dialysis, Home and Community based providers. Ensure compliance with Corporate standards and regulatory requirements and review revised language with leadership based on feedback rom assigned MHI attorney.
- Assists Manager and/or Director in the negotiation of medical group/IPA and hospital contracting.
- Advises Network Provider Contract Specialists on negotiation of individual provider and routine ancillary contracts.
- Identified as contract system lead by developing and maintaining provider contracts in contract management software.
- Targets and recruits additional providers to reduce member access grievances.
- Supports network development throughout state to including researching, recruiting and negotiating with providers.
- Participates in the evaluation of provider network and implementation of strategic plans to meet Molina's network adequacy standards.
- Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers.
- Assists in analysis and coordination of amendments, reimbursement, and language changes. Requests information of billing codes, services provided and other information needed to complete the contract profile.
- Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes.
- Assists Manager and/or Director in the completion of Block Transfer Filings
- Facilitates and resolves claim and configuration issues with impacted departments.
- Communicates proactively with other departments in order to ensure effective and efficient business results.
- Trains and monitors newly hired Contract Specialist(s).
- Participates with the management team and other committees addressing the strategic goals of the department and organization.
- Participates in other contracting related special projects as directed.
- Travels regularly throughout designated regions to meet targeted needs.
**Job Qualifications**
**REQUIRED EDUCATION** :
Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field.
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
- 5-7 years previous experience in contracting with large specialty or multispecialty provider groups.
- 3+ years experience in provider contract negotiations in a managed healthcare setting
**PREFERRED EXPERIENCE** :
Knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) contracts highly desirable.
**STATE SPECIFIC REQUIREMENTS** :
Certified Recovery Peer Specialist certification required in the state of Florida
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.
Pay Range: $60,415 - $117,809 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Provider Contracts Manager (Skilled Nursing & Care Coordination)

Posted 2 days ago
Job Viewed
Job Description
**Job Description**
**Job Summary**
Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations.
Responsible for contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and JOCs on exception, including standardized fee for service and other core payment method contracts with predefined, common programs.
Typically does not entail heavy negotiations. Minimal ongoing engagement after contract. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when applicable, and the 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.
**Job Duties**
This role negotiates assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according to departmental procedures. Contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and Joint Operating Committees on exception.
- Initiates, negotiates, generates and tracks provider Letters of Agreement, contracts and amendments from initial draft to full execution utilizing approved standardized contract templates/amendments, including but not limited to Fee for Service and Basic Alternative Payment Methods including Pay for Performance.
- Assesses and negotiates contract language for ancillary providers including, but not limited to Behaviorial Health, Home Health, Hospice, Dialysis, Home and Community based providers. Ensure compliance with Corporate standards and regulatory requirements and review revised language with leadership based on feedback rom assigned MHI attorney.
- Assists Manager and/or Director in the negotiation of medical group/IPA and hospital contracting.
- Advises Network Provider Contract Specialists on negotiation of individual provider and routine ancillary contracts.
- Identified as contract system lead by developing and maintaining provider contracts in contract management software.
- Targets and recruits additional providers to reduce member access grievances.
- Supports network development throughout state to including researching, recruiting and negotiating with providers.
- Participates in the evaluation of provider network and implementation of strategic plans to meet Molina's network adequacy standards.
- Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers.
- Assists in analysis and coordination of amendments, reimbursement, and language changes. Requests information of billing codes, services provided and other information needed to complete the contract profile.
- Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes.
- Assists Manager and/or Director in the completion of Block Transfer Filings
- Facilitates and resolves claim and configuration issues with impacted departments.
- Communicates proactively with other departments in order to ensure effective and efficient business results.
- Trains and monitors newly hired Contract Specialist(s).
- Participates with the management team and other committees addressing the strategic goals of the department and organization.
- Participates in other contracting related special projects as directed.
- Travels regularly throughout designated regions to meet targeted needs.
**Job Qualifications**
**REQUIRED EDUCATION** :
Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field.
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
- 5-7 years previous experience in contracting with large specialty or multispecialty provider groups.
- 3+ years experience in provider contract negotiations in a managed healthcare setting
**PREFERRED EXPERIENCE** :
Knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) contracts highly desirable.
**STATE SPECIFIC REQUIREMENTS** :
Certified Recovery Peer Specialist certification required in the state of Florida
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.
Pay Range: $60,415 - $117,809 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Provider Contracts Manager (Skilled Nursing & Care Coordination)

Posted 26 days ago
Job Viewed
Job Description
**Job Description**
**Job Summary**
Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations.
Responsible for contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and JOCs on exception, including standardized fee for service and other core payment method contracts with predefined, common programs.
Typically does not entail heavy negotiations. Minimal ongoing engagement after contract. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when applicable, and the 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.
**Job Duties**
This role negotiates assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according to departmental procedures. Contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and Joint Operating Committees on exception.
- Initiates, negotiates, generates and tracks provider Letters of Agreement, contracts and amendments from initial draft to full execution utilizing approved standardized contract templates/amendments, including but not limited to Fee for Service and Basic Alternative Payment Methods including Pay for Performance.
- Assesses and negotiates contract language for ancillary providers including, but not limited to Behaviorial Health, Home Health, Hospice, Dialysis, Home and Community based providers. Ensure compliance with Corporate standards and regulatory requirements and review revised language with leadership based on feedback rom assigned MHI attorney.
- Assists Manager and/or Director in the negotiation of medical group/IPA and hospital contracting.
- Advises Network Provider Contract Specialists on negotiation of individual provider and routine ancillary contracts.
- Identified as contract system lead by developing and maintaining provider contracts in contract management software.
- Targets and recruits additional providers to reduce member access grievances.
- Supports network development throughout state to including researching, recruiting and negotiating with providers.
- Participates in the evaluation of provider network and implementation of strategic plans to meet Molina's network adequacy standards.
- Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers.
- Assists in analysis and coordination of amendments, reimbursement, and language changes. Requests information of billing codes, services provided and other information needed to complete the contract profile.
- Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes.
- Assists Manager and/or Director in the completion of Block Transfer Filings
- Facilitates and resolves claim and configuration issues with impacted departments.
- Communicates proactively with other departments in order to ensure effective and efficient business results.
- Trains and monitors newly hired Contract Specialist(s).
- Participates with the management team and other committees addressing the strategic goals of the department and organization.
- Participates in other contracting related special projects as directed.
- Travels regularly throughout designated regions to meet targeted needs.
**Job Qualifications**
**REQUIRED EDUCATION** :
Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field.
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
- 5-7 years previous experience in contracting with large specialty or multispecialty provider groups.
- 3+ years experience in provider contract negotiations in a managed healthcare setting
**PREFERRED EXPERIENCE** :
Knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) contracts highly desirable.
**STATE SPECIFIC REQUIREMENTS** :
Certified Recovery Peer Specialist certification required in the state of Florida
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.
Pay Range: $60,415 - $117,809 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Provider Contracts Manager (Skilled Nursing & Care Coordination)

Posted 26 days ago
Job Viewed
Job Description
**Job Description**
**Job Summary**
Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations.
Responsible for contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and JOCs on exception, including standardized fee for service and other core payment method contracts with predefined, common programs.
Typically does not entail heavy negotiations. Minimal ongoing engagement after contract. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when applicable, and the 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.
**Job Duties**
This role negotiates assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according to departmental procedures. Contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and Joint Operating Committees on exception.
- Initiates, negotiates, generates and tracks provider Letters of Agreement, contracts and amendments from initial draft to full execution utilizing approved standardized contract templates/amendments, including but not limited to Fee for Service and Basic Alternative Payment Methods including Pay for Performance.
- Assesses and negotiates contract language for ancillary providers including, but not limited to Behaviorial Health, Home Health, Hospice, Dialysis, Home and Community based providers. Ensure compliance with Corporate standards and regulatory requirements and review revised language with leadership based on feedback rom assigned MHI attorney.
- Assists Manager and/or Director in the negotiation of medical group/IPA and hospital contracting.
- Advises Network Provider Contract Specialists on negotiation of individual provider and routine ancillary contracts.
- Identified as contract system lead by developing and maintaining provider contracts in contract management software.
- Targets and recruits additional providers to reduce member access grievances.
- Supports network development throughout state to including researching, recruiting and negotiating with providers.
- Participates in the evaluation of provider network and implementation of strategic plans to meet Molina's network adequacy standards.
- Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers.
- Assists in analysis and coordination of amendments, reimbursement, and language changes. Requests information of billing codes, services provided and other information needed to complete the contract profile.
- Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes.
- Assists Manager and/or Director in the completion of Block Transfer Filings
- Facilitates and resolves claim and configuration issues with impacted departments.
- Communicates proactively with other departments in order to ensure effective and efficient business results.
- Trains and monitors newly hired Contract Specialist(s).
- Participates with the management team and other committees addressing the strategic goals of the department and organization.
- Participates in other contracting related special projects as directed.
- Travels regularly throughout designated regions to meet targeted needs.
**Job Qualifications**
**REQUIRED EDUCATION** :
Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field.
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
- 5-7 years previous experience in contracting with large specialty or multispecialty provider groups.
- 3+ years experience in provider contract negotiations in a managed healthcare setting
**PREFERRED EXPERIENCE** :
Knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) contracts highly desirable.
**STATE SPECIFIC REQUIREMENTS** :
Certified Recovery Peer Specialist certification required in the state of Florida
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.
Pay Range: $60,415 - $117,809 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Be The First To Know
About the latest Nursing care Jobs in United States !
Provider Contracts Manager (Skilled Nursing & Care Coordination)

Posted 26 days ago
Job Viewed
Job Description
**Job Description**
**Job Summary**
Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations.
Responsible for contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and JOCs on exception, including standardized fee for service and other core payment method contracts with predefined, common programs.
Typically does not entail heavy negotiations. Minimal ongoing engagement after contract. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when applicable, and the 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.
**Job Duties**
This role negotiates assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according to departmental procedures. Contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and Joint Operating Committees on exception.
- Initiates, negotiates, generates and tracks provider Letters of Agreement, contracts and amendments from initial draft to full execution utilizing approved standardized contract templates/amendments, including but not limited to Fee for Service and Basic Alternative Payment Methods including Pay for Performance.
- Assesses and negotiates contract language for ancillary providers including, but not limited to Behaviorial Health, Home Health, Hospice, Dialysis, Home and Community based providers. Ensure compliance with Corporate standards and regulatory requirements and review revised language with leadership based on feedback rom assigned MHI attorney.
- Assists Manager and/or Director in the negotiation of medical group/IPA and hospital contracting.
- Advises Network Provider Contract Specialists on negotiation of individual provider and routine ancillary contracts.
- Identified as contract system lead by developing and maintaining provider contracts in contract management software.
- Targets and recruits additional providers to reduce member access grievances.
- Supports network development throughout state to including researching, recruiting and negotiating with providers.
- Participates in the evaluation of provider network and implementation of strategic plans to meet Molina's network adequacy standards.
- Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers.
- Assists in analysis and coordination of amendments, reimbursement, and language changes. Requests information of billing codes, services provided and other information needed to complete the contract profile.
- Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes.
- Assists Manager and/or Director in the completion of Block Transfer Filings
- Facilitates and resolves claim and configuration issues with impacted departments.
- Communicates proactively with other departments in order to ensure effective and efficient business results.
- Trains and monitors newly hired Contract Specialist(s).
- Participates with the management team and other committees addressing the strategic goals of the department and organization.
- Participates in other contracting related special projects as directed.
- Travels regularly throughout designated regions to meet targeted needs.
**Job Qualifications**
**REQUIRED EDUCATION** :
Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field.
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
- 5-7 years previous experience in contracting with large specialty or multispecialty provider groups.
- 3+ years experience in provider contract negotiations in a managed healthcare setting
**PREFERRED EXPERIENCE** :
Knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) contracts highly desirable.
**STATE SPECIFIC REQUIREMENTS** :
Certified Recovery Peer Specialist certification required in the state of Florida
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.
Pay Range: $60,415 - $117,809 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Provider Contracts Manager (Skilled Nursing & Care Coordination)

Posted 26 days ago
Job Viewed
Job Description
**Job Description**
**Job Summary**
Molina Health Plan Provider Network Contracting jobs are responsible for the network strategy and development with respect to adequacy, financial performance and operational performance, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state and local regulations.
Responsible for contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and JOCs on exception, including standardized fee for service and other core payment method contracts with predefined, common programs.
Typically does not entail heavy negotiations. Minimal ongoing engagement after contract. Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems when applicable, and the 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.
**Job Duties**
This role negotiates assigned contracts and letters of agreements with non-complex provider community that result in high quality, cost effective and marketable providers. Maintains tracking system and publish reports according to departmental procedures. Contracting/re-contracting of standard deals, maintaining network adequacy, issue escalations and Joint Operating Committees on exception.
- Initiates, negotiates, generates and tracks provider Letters of Agreement, contracts and amendments from initial draft to full execution utilizing approved standardized contract templates/amendments, including but not limited to Fee for Service and Basic Alternative Payment Methods including Pay for Performance.
- Assesses and negotiates contract language for ancillary providers including, but not limited to Behaviorial Health, Home Health, Hospice, Dialysis, Home and Community based providers. Ensure compliance with Corporate standards and regulatory requirements and review revised language with leadership based on feedback rom assigned MHI attorney.
- Assists Manager and/or Director in the negotiation of medical group/IPA and hospital contracting.
- Advises Network Provider Contract Specialists on negotiation of individual provider and routine ancillary contracts.
- Identified as contract system lead by developing and maintaining provider contracts in contract management software.
- Targets and recruits additional providers to reduce member access grievances.
- Supports network development throughout state to including researching, recruiting and negotiating with providers.
- Participates in the evaluation of provider network and implementation of strategic plans to meet Molina's network adequacy standards.
- Clearly and professionally communicates contract terms, payment structures, and reimbursement rates to physician, hospital and ancillary providers.
- Assists in analysis and coordination of amendments, reimbursement, and language changes. Requests information of billing codes, services provided and other information needed to complete the contract profile.
- Coordinates preparation and routing distribution of documents to complete the contracting process in a timely and thorough manner according to standardized processes.
- Assists Manager and/or Director in the completion of Block Transfer Filings
- Facilitates and resolves claim and configuration issues with impacted departments.
- Communicates proactively with other departments in order to ensure effective and efficient business results.
- Trains and monitors newly hired Contract Specialist(s).
- Participates with the management team and other committees addressing the strategic goals of the department and organization.
- Participates in other contracting related special projects as directed.
- Travels regularly throughout designated regions to meet targeted needs.
**Job Qualifications**
**REQUIRED EDUCATION** :
Bachelor's Degree or equivalent work experience in health care field including, but not limited to, provider's office, managed care, or other health care field.
**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** :
- 5-7 years previous experience in contracting with large specialty or multispecialty provider groups.
- 3+ years experience in provider contract negotiations in a managed healthcare setting
**PREFERRED EXPERIENCE** :
Knowledge of integrated delivery systems, hospitals and groups (specialty and ancillary) contracts highly desirable.
**STATE SPECIFIC REQUIREMENTS** :
Certified Recovery Peer Specialist certification required in the state of Florida
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.
Pay Range: $60,415 - $117,809 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Nursing Manager / Pt Care - Skilled Nursing

Posted today
Job Viewed
Job Description
**Join St. Luke's Elmore Long Term Care Team: Where Compassion Meets Care**
At St. Luke's, our dedicated team strives to build a positive, supportive, and inclusive culture that delivers exceptional resident experiences.
If you're looking for a supportive, family-like work environment where you can truly make a difference, we'd love to have you on our team!
Elmore Long Term Care is a 19 bed Long Term Care facility connected to a critical access hospital that cares for individuals who require assistance with daily living tasks. This tight-knit team supports each other in providing daily cares, emotional connection, and restorative exercises to our residents. Meaningful daily interactions and long-term stays mean deep connections can be formed with each and every individual in our care. We pride ourselves in the excellent care we provide and the incredible culture we have developed among our team.
**Position Overview**
We are looking for a compassionate and experienced Registered Nurse leader to join our Long Term Care team. What sets this LTC opportunity apart is the strong support provided by our larger healthcare system. The Nursing Manager and the unit benefit from extensive resources, including assistance with quality, accreditation, infection control, education, and clinical nurse specialist expertise. This system-wide support allows the Nursing Manager to focus on what truly matters-leading the nursing team and ensuring the delivery of exceptional resident care.
**What you can expect from this role**
+ **Schedule:** Full Time M-F 8-4 (times may vary)
+ **Professional Development** : Opportunities to participate in leadership development programs through St. Luke's and expand in leadership capacities through project management and change leadership.
+ **Patient Population** : Elderly
**Qualifications**
+ Education: Bachelors' of Nursing Degree
+ Experience: 7 years' relevant experience
+ Licenses/Certifications: Current RN License from the State of Practice and Current Basic Life Support (BLS) Provider Certified through American Safety and Health Institute, American Heart Association, or American Red Cross.
**About Mountain Home**
Mountain Home is a vibrant high-desert community rich in natural beauty and outdoor adventure. Surrounded by unique canyon lands and pristine wilderness, it offers endless opportunities for activities like hiking, fishing, rock climbing, and sand dune exploration. With 17 parks, various recreational activities, and a range of accommodations, Mountain Home caters to both fast-paced and relaxed lifestyles. The town offers a small-town atmosphere with big-city conveniences, including a museum, shops, and restaurants. Additionally, Mountain Home is near Mountain Home Air Force Base, which brings global visitors and hosts community events like an air show.
**What's in it for you**
At St. Luke's, caring for people in the communities we serve is our mission - and this includes our own SLHS team. We offer a robust benefits package to support our teams both professionally and personally. In addition to a competitive salary and retirement plans, we ensure our team feels supported in their benefits beyond the typical medical, dental, and vision offerings. We care about you and have fantastic financial and physical wellness options, such as: on-site massages, on-site counseling via our Employee Assistance Program, access to the Virgin Pulse Wellness tool, as well as other formal training and career development offerings to ensure you are meeting your career goals.
St. Luke's is an equal opportunity employer and does not discriminate against any person on the basis of race, religion, color, gender, gender identity, sexual orientation, age, national origin, disability, veteran status, or any other status or condition protected by law.
*Please note: this posting is not reflective of all job duties and responsibilities and is intended to provide an overview to job seekers.
**Default: Location : City** _Mountain Home_
**Category** _Nursing Leadership_
**Work Unit** _Skilled Nursing Elmore Hospital_
**Position Type** _Full-Time_
**Work Schedule** _VARIABLE_
**Requisition ID** _ _
**Default: Location : Location** _US-ID-Mountain Home_
**Work Location : Name** _895 N 6th E St, Mountain Home, Elmore Medical Center_