Health Plan Contracts Lead - Value-Based Network

Molina Healthcare; Dallas (TX); On-site; USD 73,000 - 143,000; Full time

Job summary

Molina Healthcare is seeking a seasoned professional to lead health plan provider network contracting efforts, negotiating complex hospital, IPA, and behavioral health agreements. You will support network strategy, drive value-based payment models, and oversee contract management processes in a highly matrixed organization.

The role requires extensive negotiation experience, data-driven decision making, and the ability to travel within Texas up to 25% to centers in Central and Northeast Texas.

Qualifications

• At least 5 years of experience in network contracting with large multispecialty provider groups.
• Experience in provider contract negotiations in a managed health care setting.
• Familiarity with Medicaid, Medicare, and Marketplace programs and value-based payment models.
• Strong negotiation and relationship-building capabilities.
• Ability to navigate complex regulatory environments.
• Data-driven decision-making and analytical abilities.

Responsibilities

• Negotiate contracts with the complex provider community to secure high quality, cost-effective plan providers.
• Manage contracts including AP M contracts and delegation oversight.
• Execute value-based contracts and provider relationship management.
• Analyze financial impact of deal terms and prepare support for executive approval.
• Develop and maintain provider contracts in contract management software.
• Recruit additional providers to reduce member access grievances.
• Engage providers in renegotiation of rates and terms; support cost-control strategies.
• Educate internal customers on contract terms, payment structures, and reimbursement rates.
• Travel up to 25% within Texas (Central & NE Texas).

Skills

Negotiation

Relationship building

Data-driven decisions

Analytical skills

Cross-functional teamwork

Communication skills

Microsoft Office

Tools

Microsoft Office

Job description

Molina Healthcare is seeking a seasoned professional to lead health plan provider network contracting efforts, negotiating complex hospital, IPA, and behavioral health agreements. You will support network strategy, drive value-based payment models, and oversee contract management processes in a highly matrixed organization.

The role requires extensive negotiation experience, data-driven decision making, and the ability to travel within Texas up to 25% to centers in Central and Northeast Texas.