Director, Health Plan Contracts & VBP Leadership

Molina Healthcare; Carson City (NV); Sur place; USD 102 000 - 199 000; Plein temps

Avantages offerts par ce poste

Competitive benefits

Résumé du poste

Molina Healthcare in Carson City, NV seeks a Senior Manager, Network Contracting to lead the provider contracting team and advance strategic, value-based payment initiatives. You will negotiate complex hospital and IPA contracts, develop standardized templates, and ensure regulatory compliance while targeting cost efficiency and network adequacy.

This role requires extensive Medicaid/Medicare experience, strong analytics, and leadership to align contracting with corporate goals and performance

Qualifications

• At least 8 years in network contracting with large specialty or multispecialty provider groups.
• At least 5 years of provider contract negotiation in a managed care setting.
• Minimum 3 years of management/leadership experience.
• Experience with Medicaid/Medicare/Marketplace compensation methodologies including VBP, FFS, capitation.
• Excellent negotiation and relationship-building capabilities.
• Strong data-driven decision-making and analytical abilities.
• Ability to navigate complex regulatory environments.
• Strong organizational skills and attention to detail.
• Ability to work cross-functionally in a matrixed organization.
• Excellent verbal and written communication skills.
• Proficiency in Microsoft Office and related software.

Responsabilités

• Oversees the plan’s provider contracting function and collaborates with stakeholders to lead or support contracting activities.
• Leads negotiations of contracts with complex providers to deliver high-quality, cost-effective agreements.
• Executes standardized APM or VBP contracts and recontracting initiatives.
• Leads initiatives, issue escalations, network adequacy, and JOCs.
• Manages and reports network adequacy for Medicare, Marketplace, and Medicaid services.
• Oversees development of provider contracting strategies including VBP across specialties and geographies.
• Leads annual savings through recontracting initiatives and cost-control measures to influence MCR.
• Negotiates provider contracts in alignment with company guidelines for physicians, hospitals, and other providers.
• Maintains contract templates and SAP/VBP program templates with legal and leadership input.
• Develops and implements new reimbursement models in collaboration with senior leadership.
• Communicates contracting strategies to network leadership and tracks activity with standardized systems.
• Participates in senior leadership committees to address department and organizational goals.

Connaissances

Negotiation

Leadership

Data-driven decisions

Regulatory navigation

Cross-functional collaboration

Outils

Microsoft Office

Description du poste

Molina Healthcare in Carson City, NV seeks a Senior Manager, Network Contracting to lead the provider contracting team and advance strategic, value-based payment initiatives. You will negotiate complex hospital and IPA contracts, develop standardized templates, and ensure regulatory compliance while targeting cost efficiency and network adequacy.

This role requires extensive Medicaid/Medicare experience, strong analytics, and leadership to align contracting with corporate goals and performance