Director, Provider Contracting & VBP Strategy

Molina Healthcare; Mesquite (NV); In loco; USD 102.000 - 199.000; Tempo pieno

Descrizione del lavoro

Molina Healthcare in Nevada seeks a Provider Contracting Director to lead the contracting function for health plan networks, negotiate complex agreements, and drive value-based payment initiatives across Medicare, Medicaid, and Marketplace programs.

You will supervise a team, develop strategies, ensure regulatory compliance, and collaborate with senior leadership to optimize network adequacy, cost controls, and contract templates.

Competenze

• 8+ years in provider contracting with multispecialty groups or large networks.
• 3+ years in management/leadership roles.
• Experience with Medicaid, Medicare, Marketplace programs.
• Strong negotiation and relationship-building abilities.
• Ability to navigate complex regulatory environments.

Mansioni

• Oversee provider contracting operations and coordinate with other departments.
• Lead negotiations with large provider groups to secure cost-effective contracts.
• Draft and re-contract with entities using APM/VBP strategies.
• Manage network adequacy reporting for Medicare, Marketplace, and Medicaid.
• Develop contracting strategies to meet MCR and cost-control goals.
• Lead implementation of standardized contract templates and VBP/P4P models.
• Track contract activity using standardized systems and reports.
• Collaborate with legal and network leadership on templates and compliance.
• Supervise team performance, training, and development.
• Engage with area agencies and partners to advance plan initiatives.

Conoscenze

Provider contract negotiations

Strategic thinking

Stakeholder management

Regulatory compliance

Analytical skills

Leadership

Negotiation

Strumenti

Microsoft Office

Descrizione del lavoro

Molina Healthcare in Nevada seeks a Provider Contracting Director to lead the contracting function for health plan networks, negotiate complex agreements, and drive value-based payment initiatives across Medicare, Medicaid, and Marketplace programs.

You will supervise a team, develop strategies, ensure regulatory compliance, and collaborate with senior leadership to optimize network adequacy, cost controls, and contract templates.