National Contracting Director (Value Based Care) - REMOTE

Lensa; Chandler (AZ); Remote; USD 107,000 - 209,000; Full time

Job summary

A leading healthcare organization is seeking a National Program Director for Value-Based Care to develop and implement innovative programs across Medicaid, Medicare, and Marketplace lines. This strategic role involves collaboration with various healthcare providers to enhance clinical and financial outcomes while ensuring health equity. The ideal candidate will have extensive experience in value-based care trends and a strong ability to lead diverse teams in a fast-paced environment.

Qualifications

• 7+ years in VBC design or provider network strategy.
• Experience across Medicaid, Medicare, and Marketplace lines.

Responsibilities

• Design and lead end-to-end value-based care programs.
• Develop contracting frameworks for various provider types.
• Analyze industry trends and performance data.

Skills

Stakeholder Engagement

Data Analysis

Communication

Education

Bachelor's Degree in Health Policy

Master’s degree in Public Health

Job description

National Contracting Director (Value Based Care) - REMOTE

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Job Description

Job Summary

The National Program Director – Value-Based Care is a strategic leadership role responsible for developing, implementing, and evolving value-based care (VBC) programs across Medicaid, Medicare, and Marketplace lines. The role focuses on driving clinical and financial performance by aligning provider incentives with quality outcomes, health equity, and cost-effective care. The Director will lead VBC program design, collaborating with diverse provider types including primary care, behavioral health, LTSS, hospitals, and community organizations.

The ideal candidate is a self-starter with expertise in VBC trends, performance levers, and risk-sharing models. They will work closely with clinical, actuarial, analytics, network, community engagement, and business teams to craft scalable VBC programs that meet diverse population needs and support RFP submissions and growth strategies.

Key Responsibilities

• Design and lead end-to-end value-based care programs tailored for Medicaid, Medicare, and Marketplace populations.
• Develop contracting frameworks inclusive of various provider types such as FQHCs, BH providers, LTSS agencies, and hospitals.
• Incorporate social determinants of health (SDOH) and health equity principles into VBC models to improve outcomes for underserved groups.
• Analyze industry trends, performance data, and regulations to inform innovative, compliant VBC designs.
• Lead VBC strategy in RFP responses, aligning with organizational goals and differentiating in procurements.
• Collaborate across teams to ensure program alignment with clinical care models and quality strategies.
• Establish metrics and monitoring to evaluate program performance and iterate based on feedback and market changes.
• Represent the organization externally as a subject matter expert at forums and stakeholder meetings.

Knowledge/Skills/Abilities

• Deep understanding of current VBC trends, payment models (shared savings, capitation, pay-for-performance), and performance levers.
• Knowledge of clinical priorities across populations and provider types, with ability to design aligned incentive programs.
• Familiarity with SDOH, health equity, and community-based care initiatives.
• Excellent stakeholder engagement and collaboration skills, influencing without authority.
• Data-driven approach with ability to interpret complex clinical, utilization, and financial data.
• Experience drafting VBC narratives for RFPs, understanding procurement scoring and positioning.
• Strong communication skills, translating strategies into actionable frameworks.
• Ability to navigate ambiguity and independently advance initiatives in a fast-paced environment.

Required Education

• Bachelor's Degree in Health Policy, Public Health, Business Administration, or related field, or equivalent experience.

Required Experience

• 7+ years in VBC design or provider network strategy.
• Experience across Medicaid, Medicare, and Marketplace lines.
• Proven success in designing, implementing, or managing VBC programs with measurable results.
• Experience working with payer organizations, provider groups, or government programs.

Preferred Education

• Master’s degree in Public Health, Health Administration, Business, or related discipline.

Preferred Experience

• Experience developing RFP content or responding to procurements.
• Experience with health equity initiatives or SDOH-focused care models.

For current Molina employees: Apply through the intranet. Molina offers competitive benefits. EOE M/F/D/V.

Pay Range: $107,028 - $208,705.4 annually. Actual compensation varies based on location, experience, education, and skills.