Senior Director, Provider Network Strategy & Contracts

Molina Healthcare; Chicago (IL); Sur place; USD 186 000 - 363 000; Plein temps

Avantages offerts par ce poste

Competitive benefits

Equal Opportunity Employer (EOE)

Résumé du poste

Molina Healthcare in Downers Grove, IL, seeks an executive leader to oversee network operations and contracting, negotiating complex agreements and aligning provider networks with strategic goals.

You will lead a team, drive performance and financial results, and implement value-based models across Medicaid, Medicare, and Marketplace programs while collaborating with stakeholders across the organization.

Qualifications

• 12+ years in health care with provider network management/contracting, health care operations, and/or government programs.
• 7+ years of management/leadership experience.
• Extensive experience in the health insurance industry.
• Strong track record of negotiating with hospitals, provider groups, IPAs.
• Expert level knowledge of reimbursement methodologies across Medicaid, Medicare, Marketplace.

Responsabilités

• Support executive strategy development and accountable performance for the network function.
• Develop and implement provider network and contract strategies to meet financial goals.
• Oversee contract negotiation activity and use contract templates compliant with regulatory requirements.
• Direct negotiations of provider contracts with physicians, hospitals and other health care providers.
• Oversee provider network administration, contract templates, and data analysis for claims payment configurations.
• Lead a high-performance team and drive collaboration across departments.

Connaissances

Leadership

Negotiation

Contracting

Provider network management

Data-driven decision-making

Project management

Relationship building

Stakeholder management

Microsoft Office

Outils

QNXT system

Microsoft Office

Description du poste

Molina Healthcare in Downers Grove, IL, seeks an executive leader to oversee network operations and contracting, negotiating complex agreements and aligning provider networks with strategic goals.

You will lead a team, drive performance and financial results, and implement value-based models across Medicaid, Medicare, and Marketplace programs while collaborating with stakeholders across the organization.