Head of Value-Based Programs & Contracts

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

Job summary

Molina Healthcare in Fort Lauderdale, FL seeks an experienced leader to drive value-based contracts and programs across Medicare and Medicaid. You will design, implement and optimize VBP/VBC strategies, manage a team, and collaborate with health plans, providers and executives to achieve financial targets and compliance.

You will oversee contract design, reporting, and risk-adjustment initiatives, set annual goals, and present performance to senior leadership while ensuring accurate data and

Qualifications

• At least 8 years of managed care experience, including value-based programs (VBP).
• At least 3 years of management/leadership experience.
• Experience designing and implementing value-based contracts for Medicaid/Medicare.
• Knowledge of risk adjustment models, HEDIS and Medicare STARS.

Responsibilities

• Design and implement value-based strategies to improve risk adjustment revenue for government lines of business.
• Lead and manage a team responsible for value-based programs and contracts planning and execution by state and LOB.
• Identify providers for value-based care contracts and negotiate terms with reporting responsibilities and benchmarks.
• Develop reports and dashboards to monitor VBP/VBC performance and ensure accurate measurement across programs.
• Collaborate with risk adjustment to align contracting strategy with needs assessment and goals.
• Present VBC/VBP/reimbursement performance to senior leadership and maintain an oversight process for contracts.

Skills

Managed care experience

Value-based programs (VBP)

Leadership experience

Executive communication

Job description

Molina Healthcare in Fort Lauderdale, FL seeks an experienced leader to drive value-based contracts and programs across Medicare and Medicaid. You will design, implement and optimize VBP/VBC strategies, manage a team, and collaborate with health plans, providers and executives to achieve financial targets and compliance.

You will oversee contract design, reporting, and risk-adjustment initiatives, set annual goals, and present performance to senior leadership while ensuring accurate data and