Director, Value-Based Programs & Contracts

Molina Healthcare; Miami (FL); Remote; USD 97,000 - 190,000; Full time

Job summary

Molina Healthcare is seeking an experienced leader to design, implement, and manage value-based contracts and programs across government-sponsored lines. The role directs a team, develops strategy, and partners with health plans to optimize value-based reimbursement and risk-sharing initiatives.

The ideal candidate will oversee contract design, performance reporting, and stakeholder engagement to achieve financial and care-quality goals on Medicaid, Medicare, and related programs.

Qualifications

• 8+ years of managed care experience, including value-based programs (VBP).
• 3+ years of management/leadership experience.
• Experience designing and implementing value-based contracts for Medicaid/Medicare.
• Experience in government-sponsored programs, risk revenue management and compliance.
• Knowledge of VBP, risk adjustment models, and quality metrics (HEDIS/STAR).
• Knowledge of medical economics and financial reporting.
• Strong leadership and strategic execution across a matrixed org.
• Excellent verbal and written communication; proficient with MS Office.

Responsibilities

• Design and implement strategies to improve VBP results and drive innovation.
• Lead VBP programs and contracts planning by state and LOB.
• Identify providers for VBC contracts; set annual targets and reporting.
• Collaborate with risk adjustment to guide contracting strategies.
• Develop dashboards to monitor VBP/VBC metrics and progress.
• Support market launches and expansion of value-based programs.
• Present performance to senior leadership; ensure accurate reporting.
• Hire, train, and manage team performance; drive collaboration.

Skills

Leadership

Strategic thinking

Financial acumen

Risk adjustment

VBP knowledge

Stakeholder management

Executive communication

MS Office proficiency

Tools

Microsoft Office

Job description

Molina Healthcare is seeking an experienced leader to design, implement, and manage value-based contracts and programs across government-sponsored lines. The role directs a team, develops strategy, and partners with health plans to optimize value-based reimbursement and risk-sharing initiatives.

The ideal candidate will oversee contract design, performance reporting, and stakeholder engagement to achieve financial and care-quality goals on Medicaid, Medicare, and related programs.