Senior Director, Value-Based Contracting Strategy (Remote)

Molina Healthcare; United States; On-site; USD 141,000 - 275,000; Full time

Job summary

Molina Healthcare seeks a senior leader to provide strategy and leadership for the value-based contracting (VBC) portfolio across the enterprise. You will negotiate, implement, and expand VBC partnerships, collaborating with network, medical economics, risk adjustment, quality, finance, and IT.

This role requires deep expertise in reimbursement methodologies and a track record of managing complex external partnerships, as well as driving cross-functional initiatives.

Qualifications

• 10+ years in network contracting and 8+ years in value-based care (VBC) contracting.
• 5+ years of management/leadership experience.
• Extensive experience in the health insurance industry.
• Expert level knowledge of reimbursement methodologies for value-based contracts across all lines of business (Medicaid, Medicare, Marketplace).
• Strong experience with various managed health care provider compensation methodologies.
• Excellent negotiation and relationship-building capabilities.
• Ability to navigate complex regulatory environments.
• Data-driven decision-making skills and strong analytical abilities.
• Strong organizational skills and attention to detail.
• Ability to work cross-functionally with internal/external stakeholders in a highly matrixed organization.
• Ability to manage multiple tasks and deadlines effectively.
• Strong project management skills.
• Excellent verbal and written communication skills and ability to present at an executive level.
• Microsoft Office suite and applicable software programs proficiency.

Responsibilities

• Leads strategy development and direction for value-based contracting (VBC) across the Molina enterprise.
• Negotiates, implements, and expands VBC portfolios nationally and at the state level.
• Identifies and negotiates value-based contracts to lower total cost of health care.
• Contributes to national network leadership and aligns stakeholders around a unified VBC operating model.
• Defines guidelines for VBC and analytics, data, and reconciliation with providers.
• Ensures alignment with key stakeholders across network, medical economics, EIM/IT, actuarial, finance, risk adjustment, and quality.
• Implements and executes the enterprise-wide VBC operating model.
• Provides monthly reporting to executive leadership.
• Maintains partnerships with medical economics, network, actuary, finance, EIM, and IT to optimize VBC processes and technology.
• Manages multiple, complex VBC and cross-enterprise projects.
• Hires, trains, and evaluates team members, coaching and developing staff.
• Develops and sustains a high-performance team delivering best-in-class solutions.
• Some travel to markets may be required (up to 15%).

Skills

Leadership

Negotiation

Analytics

Project management

Communication

Cross-functional work

Strategic thinking

Stakeholder management

Tools

Microsoft Office

Job description

Molina Healthcare seeks a senior leader to provide strategy and leadership for the value-based contracting (VBC) portfolio across the enterprise. You will negotiate, implement, and expand VBC partnerships, collaborating with network, medical economics, risk adjustment, quality, finance, and IT.

This role requires deep expertise in reimbursement methodologies and a track record of managing complex external partnerships, as well as driving cross-functional initiatives.