Value-Based Health Plan Provider Contracts Lead

Molina Healthcare; Grand Rapids (MI); On-site; USD 73,000 - 143,000; Full time

Benefits offered by this job

Competitive benefits

Job summary

Molina Healthcare in the United States seeks an experienced Network Contracting leader to oversee complex provider agreements and value-based payment strategies. You will negotiate with physician groups, hospitals, and ancillary providers to secure high-quality, cost-effective contracting terms.

Responsibilities include leading contract development, managing large-scale relationships, and guiding regional strategies to meet network adequacy standards.

Qualifications

• 5+ years of experience in network contracting with large provider groups, including complex agreements.
• Familiarity with Medicaid/Medicare value-based payment, FFS, capitation, and risk sharing models.
• Strong negotiation, relationship building, and regulatory navigation abilities.

Responsibilities

• Negotiate contracts and letters of agreement with complex provider communities to secure high quality, cost-effective plan providers.
• Manage contracts with large entities, including PADU guidelines and alternative payment models.
• Lead execution and optimization of value-based contracts and provider relationship management.
• Analyze financial impact of deal terms and prepare escalation-ready justifications for approvals.
• Develop and maintain provider contracts in contract management systems.
• Target and recruit providers to reduce member access issues and renegotiate terms when needed.
• Educate internal customers on contract terms, payment structures, and reimbursement rates.

Skills

Negotiation

Relationship building

Data analysis

Regulatory navigation

Communication

Cross-functional teamwork

Attention to detail

Microsoft Office

Tools

Contract management software

Job description

Molina Healthcare in the United States seeks an experienced Network Contracting leader to oversee complex provider agreements and value-based payment strategies. You will negotiate with physician groups, hospitals, and ancillary providers to secure high-quality, cost-effective contracting terms.

Responsibilities include leading contract development, managing large-scale relationships, and guiding regional strategies to meet network adequacy standards.