Remote Health Plan Contracts Leader - NY/Tri-State

Molina Healthcare; New York (NY); On-site; USD 110,000 - 170,000; Full time

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare is seeking an experienced Network Contracting leader to oversee complex provider agreements, including high-priority hospitals and physician groups, across Medicaid and Medicare markets. The role emphasizes value-based models, cost control, and network adequacy.

You will guide negotiations, manage contracts, and collaborate with executives to ensure favorable terms while maintaining regulatory compliance.

Qualifications

• 5+ years in network contracting with large provider groups and 3+ years in provider contract negotiations in managed care
• Experience across Medicaid, Medicare, and Marketplace lines of business with VBP, FFS, capitation, and risk-based models
• Strong negotiation and relationship-building capabilities
• Ability to navigate complex regulatory environments and work cross-functionally with stakeholders

Responsibilities

• Negotiate contracts and letters of agreement with complex providers to secure high quality, cost-effective plan providers
• Execute and manage value-based contracts and enhanced provider relationships
• Analyze financial impact of deal terms and prepare justification for executive approval
• Develop and maintain provider contracts in contract management software
• Target and recruit providers to improve member access and reduce grievances
• Train and mentor contracting team members and participate in regional travel as needed

Skills

Negotiation

Contract management

Data analysis

Regulatory compliance

Stakeholder management

Communication

Tools

Microsoft Office

Contract management software

Job description

Molina Healthcare is seeking an experienced Network Contracting leader to oversee complex provider agreements, including high-priority hospitals and physician groups, across Medicaid and Medicare markets. The role emphasizes value-based models, cost control, and network adequacy.

You will guide negotiations, manage contracts, and collaborate with executives to ensure favorable terms while maintaining regulatory compliance.