Provider Contracts Manager, Health Plan — Value-Based

Molina Healthcare; Flint, Northern (MI, KY); On-site; USD 73,000 - 143,000; Full time

Job summary

Molina Healthcare in Flint, MI seeks an experienced leader for complex provider contracting to support network adequacy, financial performance, and operational goals. This role negotiates and manages high-stakes agreements across physician, hospital, and ancillary providers, including value-based models.

Responsibilities include developing and maintaining contracts, guiding PADU-based negotiations, mentoring staff, and traveling regionally to recruit and renegotiate terms with targeted

Qualifications

• At least 5 years of network contracting experience with large provider groups.
• 3+ years negotiating provider contracts in managed health care.
• Experience with Medicaid/Medicare value-based payment, FFS, capitation, and risk.
• Negotiation and relationship-building capabilities.
• Ability to navigate complex regulatory environments.
• Data-driven decision making and analytical abilities.
• Strong organizational and detail-oriented skills.
• Ability to work cross-functionally with stakeholders.
• Effective verbal and written communication skills.
• Proficiency with Microsoft Office and related software.

Responsibilities

• Negotiate contracts and letters with complex provider groups to secure high quality plans.
• Contract large scale entities with custom reimbursement and APM models.
• Execute value-based contracts and manage provider relationships.
• Analyze financial impact of deal terms for executive approval.
• Lead negotiation of complex provider contracts using PADU guidelines.
• Develop and maintain provider contracts in contract management software.
• Target and recruit providers to reduce member access grievances.
• Renegotiate rates and terms to improve medical cost ratios.
• Advise team on negotiation of provider and routine contracts.
• Maintain relationships with significant providers and ensure adequacy.

Skills

Negotiation

Relationship building

Data-driven decisions

Analytical abilities

Organizational skills

Cross-functional collaboration

Regulatory navigation

Verbal and written communication

Microsoft Office proficiency

Tools

Contract management software

Microsoft Office

Job description

Molina Healthcare in Flint, MI seeks an experienced leader for complex provider contracting to support network adequacy, financial performance, and operational goals. This role negotiates and manages high-stakes agreements across physician, hospital, and ancillary providers, including value-based models.

Responsibilities include developing and maintaining contracts, guiding PADU-based negotiations, mentoring staff, and traveling regionally to recruit and renegotiate terms with targeted