Senior New York Health Plan Provider Contracts Lead

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

Job summary

Molina Healthcare in New York seeks a senior contract professional to provide subject matter expertise and leadership for health plan provider network contracting activities. You will negotiate and manage agreements with hospitals, IPAs, behavioral health entities, and ancillary providers, directing complex reimbursement models and ensuring regulatory compliance.

Responsibilities include driving network adequacy, conducting financial impact analyses, and developing contracts in management

Qualifications

• At least 5 years of network contracting experience with large provider groups.
• 3+ years negotiating provider contracts in managed care (physician/group/hospital).
• Familiar with Medicaid/Medicare compensation methodologies and VBP/FFS/capitation.

Responsibilities

• Negotiate contracts with behavioral health providers and large networks.
• Execute, manage, and optimize provider contracts and re-contracts.
• Analyze financial impact of deal terms and justify for exec approval.
• Develop provider contracts in contract management systems and support PADU guidelines.
• Engage providers, renegotiate rates/language, and assist with cost-control strategies.
• Educate internal customers on contract terms and payment structures.
• Travel within New York state approximately 3–10%.

Skills

Negotiation

Data-driven decisions

Analytical skills

Communication

Organizational skills

Cross-functional teamwork

Attention to detail

Tools

Microsoft Office

Contract management software

Docusign

Salesforce

Job description

Molina Healthcare in New York seeks a senior contract professional to provide subject matter expertise and leadership for health plan provider network contracting activities. You will negotiate and manage agreements with hospitals, IPAs, behavioral health entities, and ancillary providers, directing complex reimbursement models and ensuring regulatory compliance.

Responsibilities include driving network adequacy, conducting financial impact analyses, and developing contracts in management