Head of Health Plan Contracts & Value-Based Partnerships

Molina Healthcare; Carson City (NV); On-site; USD 102,000 - 199,000; Full time

Job summary

Molina Healthcare is seeking a Provider Contracting Director to lead the provider contracting function in Nevada. You will negotiate complex contracts including APMs and VBPs, develop strategies with senior leadership, and manage alliances with hospitals, IPAs, and large provider networks.

This role emphasizes cost control, network adequacy reporting for Medicare/Medicaid, and driving annual savings while ensuring compliance with NCQA/HEDIS and regulatory requirements.

Qualifications

• 8+ years in network contracting with large multispecialty groups.
• 5+ years in provider contract negotiations in a managed care setting.
• 3+ years of management/leadership experience.
• Experience with Medicaid/Medicare/Marketplace programs.
• Strong negotiation and relationship-building capabilities.
• Ability to navigate complex regulatory environments.
• Data-driven decision making and analytical abilities.
• Excellent verbal and written communication; MS Office proficiency.

Responsibilities

• Oversees the plan’s provider contracting function and daily operations.
• Leads negotiations of contracts with complex provider groups to secure high-quality, cost-effective providers.
• Executes standardized APM/VBP contracts and re-contracting initiatives.
• Oversees network adequacy reporting for Medicare, Marketplace, and Medicaid.
• Develops contracting strategies with senior leadership to meet Molina goals.
• Drives annual savings through recontracting and cost-control measures.
• Maintains contract templates and ensures regulatory/commercial compliance.
• Hires, trains and evaluates team performance and facilitates collaboration.

Skills

Negotiation

Leadership

Regulatory know-how

Data analytics

Cross-functional

Project management

Communication

MS Office

Healthcare contracts

Education

Tools

Contract management system

Job description

Molina Healthcare is seeking a Provider Contracting Director to lead the provider contracting function in Nevada. You will negotiate complex contracts including APMs and VBPs, develop strategies with senior leadership, and manage alliances with hospitals, IPAs, and large provider networks.

This role emphasizes cost control, network adequacy reporting for Medicare/Medicaid, and driving annual savings while ensuring compliance with NCQA/HEDIS and regulatory requirements.