Senior Health Plan Provider Contracts Manager

Molina Healthcare, Inc.; New York (NY); Sur place; USD 130 000 - 170 000; Plein temps

Résumé du poste

Molina Healthcare, Inc. is seeking an experienced leader for health plan provider network contracting.

The role provides subject matter expertise, negotiates complex agreements with hospitals, IPAs, and behavioral health organizations, and supports network adequacy and performance through strategic contracting initiatives. Key duties include negotiating high-value contracts, managing contract terms and reimbursements, and guiding negotiations within PADU guidelines to improve value-based care

Qualifications

• 5+ years of experience in network contracting with large specialty or multispecialty provider groups, and 3+ years in provider contract negotiations.
• Familiarity with Medicaid/Medicare reimbursement methodologies including VBP, FFS, capitation and risk forms.
• Strong negotiation and relationship-building capabilities.
• Ability to navigate complex regulatory environments.
• Data-driven decision making and analytical abilities.
• Ability to work cross-functionally in a matrixed organization.

Responsabilités

• Negotiate contracts with Behavioral Health Providers within complex provider community.
• Execute and manage provider contracts, including complex and high-priority agreements.
• Develop and maintain provider contracts in contract management software.
• Advise internal teams and executives on contract terms and payment structures.
• Participate in fee schedule determinations and development of new reimbursement models.
• Travel approximately 3-10% within New York state.
• Provide training and mentorship to contracting team members.

Connaissances

Negotiation

Relationship building

Data-driven decisions

Organizational skills

Regulatory navigation

Cross-functional collaboration

Verbal and written communication

MS Office proficiency

Outils

Docusign

Salesforce

Contract management software

MS Office

Description du poste

Molina Healthcare, Inc. is seeking an experienced leader for health plan provider network contracting.

The role provides subject matter expertise, negotiates complex agreements with hospitals, IPAs, and behavioral health organizations, and supports network adequacy and performance through strategic contracting initiatives. Key duties include negotiating high-value contracts, managing contract terms and reimbursements, and guiding negotiations within PADU guidelines to improve value-based care