Remote Health Plan Contracts Leader NY/Tri-State

Molina Healthcare; New York (NY); Remote; USD 73,000 - 171,000; Full time

Job summary

Molina Healthcare in NY/Tristate remote role seeks a senior network contracting professional to manage complex provider agreements and lead value-based models. You will negotiate with hospitals, IPAs, and behavioral health entities while guiding strategy for provider adequacy and cost performance.

Responsibilities include financial impact analysis, regulatory compliance, and mentoring team members across regions. Strong negotiation, data literacy, and collaboration are essential.

Qualifications

• At least 5 years of experience in network contracting with large specialty or multispecialty provider groups.
• Experience negotiating provider contracts in a managed health care setting, across physician/group/hospital types.
• Familiarity with Medicaid and Medicare value-based payment models and related risk arrangements.
• Strong negotiation and relationship-building capabilities.
• Ability to navigate complex regulatory environments.
• Data-driven decision-making and strong analytical skills.
• Proficiency with Microsoft Office and related software.

Responsibilities

• Negotiate contracts and letters of agreement with complex providers to secure high-quality, cost-effective plan providers.
• Manage contracts, including complex reimbursement and value-based models; support regional delegation oversight.
• Lead analysis of financial impact of deal terms for executive review and approval.
• Negotiate PADU-based language for high-priority provider groups and hospitals.
• Develop and maintain provider contracts in contract management software; support regional strategy.
• Educate internal customers on contract terms and reimbursement structures.
• Travel regularly throughout designated regions to meet targeted needs.

Skills

Negotiation

Contract management

Data analysis

Regulatory compliance

Cross-functional collaboration

Microsoft Office

Tools

Contract management software

Job description

Molina Healthcare in NY/Tristate remote role seeks a senior network contracting professional to manage complex provider agreements and lead value-based models. You will negotiate with hospitals, IPAs, and behavioral health entities while guiding strategy for provider adequacy and cost performance.

Responsibilities include financial impact analysis, regulatory compliance, and mentoring team members across regions. Strong negotiation, data literacy, and collaboration are essential.