Director, Health Plan Contracts & Value-Based Partnerships

Molina Healthcare; Nevada; On-site; USD 102,000 - 199,000; Full time

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare in Nevada seeks a seasoned leader to direct the health plan provider network contracting function. You will negotiate complex contracts, including alternative payment models and value-based arrangements, and collaborate with senior leadership to align strategies with plan goals.

Responsibilities include overseeing contract templates, ensuring regulatory compliance, driving cost savings, and reporting network adequacy across Medicare, Marketplace, and Medicaid programs, while

Qualifications

• Minimum 8 years in network contracting with large provider groups.
• At least 3 years of management/leadership experience.
• Experience with Medicaid/Medicare/Marketplace programs.
• Strong negotiation and relationship-building skills.
• Ability to navigate complex regulatory environments.
• Strong data-driven decision making and analytical abilities.
• Excellent verbal and written communication skills.
• Proficiency with Microsoft Office and related software.

Responsibilities

• Oversee daily operations of provider contracting.
• Lead negotiations with the complex provider community.
• Develop and implement contracting strategies including VBP and APM.
• Ensure network adequacy and reporting for Medicare/Marketplace/Medicaid.
• Maintain and modify contract templates with legal teams.
• Collaborate with senior leadership on contracting initiatives.
• Drive cost savings and MCR improvements.
• Oversee negotiation of provider contracts including VBP.

Skills

Negotiation

Management experience

Data-driven decisions

Analytical abilities

Communication skills

MS Office proficiency

Regulatory navigation

Cross-functional collaboration

Tools

Excel

Contract management software

Job description

Molina Healthcare in Nevada seeks a seasoned leader to direct the health plan provider network contracting function. You will negotiate complex contracts, including alternative payment models and value-based arrangements, and collaborate with senior leadership to align strategies with plan goals.

Responsibilities include overseeing contract templates, ensuring regulatory compliance, driving cost savings, and reporting network adequacy across Medicare, Marketplace, and Medicaid programs, while