Director, Value-Based Programs & Contracts

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

Job summary

Molina Healthcare is seeking an experienced senior leader to design and implement value-based contracts and programs across Medicare, Medicaid and other government lines of business. You will lead a team responsible for value-based strategies, contract design, reporting, and senior leadership communications, ensuring accuracy, compliance, and financial objectives through risk-sharing arrangements.

The role requires collaboration with plan partners, providers, and finance to drive performance and

Qualifications

• 8+ years of managed care experience with value-based programs (VBP).
• 3+ years of management/leadership experience.
• Experience designing and implementing Medicaid, Medicare, and/or Marketplace VBP contracts.
• Experience in government-sponsored programs including risk revenue management.
• Knowledge of VBP, risk adjustment models, HEDIS, and Medicare STARS.
• Knowledge of medical economics, financial reporting, and complex reconciliations.
• Strong leadership, strategic thinking, and cross-functional collaboration.
• Proficiency with Microsoft Office and related software.

Responsibilities

• Design and implement strategies to improve results of value-based initiatives and innovate new ones.
• Lead VBP/VBC programs and contract plans by state and by line of business.
• Identify providers for value-based care contracts and set annual targets and reporting.
• Develop and share reporting for local health plan resources to meet goals.
• Collaborate with risk adjustment to guide contracting strategy and program goals.
• Present VBC/VBP performance to senior leadership and design oversight processes.
• Hire, train, manage and evaluate team performance; coach and develop staff.
• Foster a high-performance team to attract, develop and retain top talent.

Skills

Leadership

Strategic thinking

Verbal and written communication

Stakeholder management

Tools

Microsoft Office Suite

Job description

Molina Healthcare is seeking an experienced senior leader to design and implement value-based contracts and programs across Medicare, Medicaid and other government lines of business. You will lead a team responsible for value-based strategies, contract design, reporting, and senior leadership communications, ensuring accuracy, compliance, and financial objectives through risk-sharing arrangements.

The role requires collaboration with plan partners, providers, and finance to drive performance and