Provider Network Management Jobs in USA with Visa Sponsorship
Provider Network Management roles attract consistent H-1B visa and E-3 visa sponsorship from health insurers, managed care organizations, and hospital systems. Most positions require a bachelor's degree in health administration, business, or a related field, with employer petition approval rates above the national average. For detailed occupation requirements, see the O*NET profile.
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Get Access To All JobsJOB SUMMARY
Provides strategy and leadership to team responsible for network operations and contracting activities. Supports network strategy and development with respect to adequacy, financial performance and operational performance. Also responsible for negotiating complex contracts that are strategically critical to plan/product success, including but not limited to: alternative payment models (APMs), value-based payment (VBP) contracts and capitated payments for hospitals, independent physician associations (IPAs), and complex behavioral health arrangements. Establishes and maintains a distinct high-performing and adequate network of compassionate and culturally sensitive providers aligned with Molina's mission, vision and values.
ESSENTIAL JOB DUTIES
- Supports strategy development, vision and direction for the network function. Demonstrates accountability for performance and financial results, and keeps executive leadership apprised.
- Develops and implements provider network and contract strategies - identifying specialties and geographic locations to concentrate resources for the purpose of establishing a sufficient network of participating providers to serve the health care needs of Molina's membership and meet established financial goals.
- Develops and maintains a market-specific provider reimbursement strategy consistent with reimbursement tolerance parameters (across multiple specialties/geographies); oversees the development of new reimbursement models, and obtains input from corporate and legal on new reimbursement models.
- Develops and maintains a system to track contract negotiation activity on an ongoing basis throughout the year; utilizes and oversees departmental training on the contract management system.
- Directs the preparation and negotiations of provider contracts and oversees negotiation of contracts in concert with established company templates and guidelines related to contracting with physicians, hospitals, and other health care providers.
- Contributes as a key member of the senior leadership team and other committees; responsible to address the strategic goals of the department and organization.
- Oversees the maintenance of all provider contract information, provider contract templates and ensure that all contracts negotiated can be configured in the QNXT system; collaborates with legal and corporate on an as needed basis to modify contract templates to ensure compliance with all contractual and/or regulatory requirements.
- Oversees plan-specific fee schedule management.
- Develops strategies to improve EDI/MASS rates.
- Provides oversight of provider services and coordinates activities with provider associations and joint operating committee (JOC) leadership.
- Provides accountability for the delegation oversight function in the plan.
- Provides oversight of the provider network administration area including: provider information management and business analyses of contracts and benefits to support accurate configuration for claims payment.
- Oversees all provider/member problem prevention, research and resolution, and provides oversight of the provider/member appeals and grievance process.
- Coordinates with enrollment growth to ensure that Molina grows faster (profitable growth) than competitors in key provider practices.
- Hires, trains, manages and evaluates team member performance - provides coaching, development, and recognition; ensures ongoing appropriate staff training, holds regular team meetings, and drives communication and collaboration.
- Develops and sustains a high-performance team, dedicated to best in class solutions; responsible for attracting, developing and retaining top-tier talent to support strategy and long-term business objectives.
REQUIRED QUALIFICATIONS
- At least 10 years of experience in health care to include experience in provider network management/contracting, health care operations, and/or government-sponsored programs, and at least 8 years of senior level network operations experience, or equivalent combination of relevant education and experience.
- At least 5 years of management/leadership experience.
- Extensive experience in the health insurance industry.
- Track record of strong relationships with hospitals, provider groups, and independent physician associations (IPAs).
- Expert level knowledge regarding reimbursement methodologies across all lines of business (Medicaid, Medicare, Marketplace).
- Strong experience with various managed health care provider compensation methodologies.
- Excellent negotiation and relationship building capabilities.
- Ability to navigate complex regulatory environments.
- Strong data-driven decision-making skills, and analytical abilities.
- Strong organizational skills and attention to detail.
- Ability to work cross-functionally with internal/external stakeholders in a highly matrixed organization, and influence business decisions.
- Ability to manage multiple tasks and deadlines effectively.
- Strong project management skills.
- Excellent verbal and written communication skills, and ability to present at an executive level.
- Microsoft Office suite and applicable software programs proficiency.
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
- Pay Range: $140,795 - $274,550.26 / ANNUAL
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
JOB SUMMARY
Provides strategy and leadership to team responsible for network operations and contracting activities. Supports network strategy and development with respect to adequacy, financial performance and operational performance. Also responsible for negotiating complex contracts that are strategically critical to plan/product success, including but not limited to: alternative payment models (APMs), value-based payment (VBP) contracts and capitated payments for hospitals, independent physician associations (IPAs), and complex behavioral health arrangements. Establishes and maintains a distinct high-performing and adequate network of compassionate and culturally sensitive providers aligned with Molina's mission, vision and values.
ESSENTIAL JOB DUTIES
- Supports strategy development, vision and direction for the network function. Demonstrates accountability for performance and financial results, and keeps executive leadership apprised.
- Develops and implements provider network and contract strategies - identifying specialties and geographic locations to concentrate resources for the purpose of establishing a sufficient network of participating providers to serve the health care needs of Molina's membership and meet established financial goals.
- Develops and maintains a market-specific provider reimbursement strategy consistent with reimbursement tolerance parameters (across multiple specialties/geographies); oversees the development of new reimbursement models, and obtains input from corporate and legal on new reimbursement models.
- Develops and maintains a system to track contract negotiation activity on an ongoing basis throughout the year; utilizes and oversees departmental training on the contract management system.
- Directs the preparation and negotiations of provider contracts and oversees negotiation of contracts in concert with established company templates and guidelines related to contracting with physicians, hospitals, and other health care providers.
- Contributes as a key member of the senior leadership team and other committees; responsible to address the strategic goals of the department and organization.
- Oversees the maintenance of all provider contract information, provider contract templates and ensure that all contracts negotiated can be configured in the QNXT system; collaborates with legal and corporate on an as needed basis to modify contract templates to ensure compliance with all contractual and/or regulatory requirements.
- Oversees plan-specific fee schedule management.
- Develops strategies to improve EDI/MASS rates.
- Provides oversight of provider services and coordinates activities with provider associations and joint operating committee (JOC) leadership.
- Provides accountability for the delegation oversight function in the plan.
- Provides oversight of the provider network administration area including: provider information management and business analyses of contracts and benefits to support accurate configuration for claims payment.
- Oversees all provider/member problem prevention, research and resolution, and provides oversight of the provider/member appeals and grievance process.
- Coordinates with enrollment growth to ensure that Molina grows faster (profitable growth) than competitors in key provider practices.
- Hires, trains, manages and evaluates team member performance - provides coaching, development, and recognition; ensures ongoing appropriate staff training, holds regular team meetings, and drives communication and collaboration.
- Develops and sustains a high-performance team, dedicated to best in class solutions; responsible for attracting, developing and retaining top-tier talent to support strategy and long-term business objectives.
REQUIRED QUALIFICATIONS
- At least 10 years of experience in health care to include experience in provider network management/contracting, health care operations, and/or government-sponsored programs, and at least 8 years of senior level network operations experience, or equivalent combination of relevant education and experience.
- At least 5 years of management/leadership experience.
- Extensive experience in the health insurance industry.
- Track record of strong relationships with hospitals, provider groups, and independent physician associations (IPAs).
- Expert level knowledge regarding reimbursement methodologies across all lines of business (Medicaid, Medicare, Marketplace).
- Strong experience with various managed health care provider compensation methodologies.
- Excellent negotiation and relationship building capabilities.
- Ability to navigate complex regulatory environments.
- Strong data-driven decision-making skills, and analytical abilities.
- Strong organizational skills and attention to detail.
- Ability to work cross-functionally with internal/external stakeholders in a highly matrixed organization, and influence business decisions.
- Ability to manage multiple tasks and deadlines effectively.
- Strong project management skills.
- Excellent verbal and written communication skills, and ability to present at an executive level.
- Microsoft Office suite and applicable software programs proficiency.
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
- Pay Range: $140,795 - $274,550.26 / ANNUAL
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
See all 12+ Provider Network Management jobs
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Get Access To All JobsTips for Finding Provider Network Management Jobs
Target managed care organizations first
Large insurers and managed care organizations file the most H-1B petitions for network management roles. They have established immigration infrastructure, legal teams, and HR processes that make sponsorship faster and less bureaucratic than smaller regional health systems.
Align your degree field precisely
USCIS requires your degree to relate directly to provider network management. Health administration, business administration, public health, and healthcare management degrees have the strongest track record. A mismatch between degree field and job duties is a common reason for RFEs.
Emphasize credentialing and contracting experience
Employers sponsoring visas for this role want demonstrable experience with provider credentialing, contract negotiation, or network adequacy analysis. Quantify your impact where possible. Vague claims about managing relationships carry less weight in sponsorship petitions than specific operational outcomes.
Understand the LCA wage requirements
Your employer must certify your offered compensation meets prevailing wage levels for your geographic area before filing. Roles in major metro markets often carry higher prevailing wage thresholds. Confirm the wage tier with your employer's immigration counsel before accepting an offer.
Ask about cap-exempt employer eligibility
Nonprofit hospitals and academic medical centers affiliated with universities may qualify as cap-exempt H-1B employers. This means they can file petitions year-round without waiting for the lottery, giving you significantly more flexibility in timing your start date and job transition.
Prepare for specialty occupation scrutiny
USCIS has issued RFEs on network management roles questioning whether they meet specialty occupation standards. Your employer's petition should document that the position routinely requires theoretical and practical application of highly specialized health administration knowledge at the bachelor's level or above.
Provider Network Management jobs are hiring across the US. Find yours.
Find Provider Network Management JobsFrequently Asked Questions
Do Provider Network Management roles commonly get H-1B sponsorship?
Yes, particularly at large health insurers, Blue Cross Blue Shield affiliates, and national managed care organizations like UnitedHealth Group and Cigna. These employers file H-1B petitions for network management positions regularly and have dedicated immigration counsel. Smaller regional networks sponsor less frequently, so targeting larger organizations improves your chances significantly. Browse sponsoring employers on Migrate Mate to identify which ones are actively hiring.
What degree does USCIS expect for a Provider Network Management visa petition?
USCIS looks for a bachelor's degree or higher in health administration, healthcare management, public health, or business administration with a healthcare concentration. Degrees in unrelated fields, even combined with years of experience, can trigger a Request for Evidence. If your degree is in a tangential field, your employer's attorney will need to build a strong nexus argument tying your coursework directly to the role's specialized duties.
What is the H-1B approval rate for Provider Network Management positions?
USCIS doesn't publish approval rates broken down to this specific title, but health services management roles broadly see approval rates above the overall H-1B average when petitions are well-documented. The most common denial reason is failing the specialty occupation test, which can occur if the job description is written too broadly or doesn't clearly require a specific degree field. A precise, detailed job description from your employer's counsel materially improves outcomes.
Can I get an E-3 visa for a Provider Network Management role if I'm Australian?
Yes. Provider Network Management qualifies as a specialty occupation under E-3 criteria provided the role genuinely requires a bachelor's degree in a specific field and your degree matches. Australian applicants benefit from the E-3's no-lottery structure, meaning you can apply year-round through a consular interview. Your employer still needs to file a certified Labor Condition Application before your interview, which typically takes one to two weeks.
How do I find Provider Network Management jobs that offer visa sponsorship?
Most general job boards don't filter by sponsorship willingness, which means significant time spent on applications that lead nowhere for visa-dependent candidates. Migrate Mate is built specifically for this, listing Provider Network Management roles from employers with verified sponsorship track records. Filtering by visa type lets you focus exclusively on opportunities where sponsorship is already on the table, which is especially important if you're working against an OPT or grace period deadline.
What is the prevailing wage requirement for sponsored Provider Network Management jobs?
U.S. employers sponsoring a visa must pay at least the prevailing wage, which is what workers in the same role, area, and experience level typically earn. The Department of Labor sets this rate to make sure companies aren't hiring foreign workers simply because they'd accept lower pay than a U.S. worker. It varies by job title, location, and experience. You can look up current prevailing wage rates for any occupation and location using the OFLC Wage Search page.
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